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Approach to the Patient with Moderate Hypertriglyceridemia.

Hypertriglyceridemia is a common lipid disorder encountered in clinical practice. Plasma triglycerides are a marker for the concentration of triglycerides carried in chylomicrons and very low density lipoprotein (VLDL) particles. A fasting triglyceride level under 150mg/dL is accepted widely as the upper limit of normal range. Guidelines for hypertriglyceridemia are variable without a global consensus on classification and goals for triglyceride levels. A general classification of hypertriglyceridemia is mild <200 mg/dL, moderate 200-500 mg/dL, moderate to severe 500-1000 mg/dL and severe >1000 mg/dL. Because moderate hypertriglyceridemia does increase atherosclerotic cardiovascular disease risk, it is important to determine the underlying etiology to guide appropriate and timely management. This article provides step-wise recommendations on the diagnosis and management of moderate hypertriglyceridemia, based on three common scenarios encountered in clinical practice. Initial steps in management include evaluating for secondary contributors, especially diabetes mellitus. Based on patient characteristics, appropriate management decisions include lifestyle adjustments aimed at weight loss and decreasing alcohol consumption and use of statin and non-statin therapies.