Clinical Management
of Hypertriglyceridemia
As in hypercholesterolemia, the non-pharmacologic management is much the same with the exception of a few caveats. Patients with hypertriglyceridemia are extremely sensitive to weight loss, generally much more so than patients with hypercholesterolemia. Diet and exercise are, therefore, important. Also simple sugars and alcohol should be avoided. Diabetes should be controlled and some drugs like birth control pills or beta blockers may need to be discontinued.
Patients with fasting triglycerides greater than 500 mg/dl and who have failed non-pharmacologic therapy should be treated with drug therapy. These patients often have post-prandial triglycerides in excess of 1000 mg/dl putting them at risk for developing pancreatitis. They should be aggressively treated.
Niacin and gemfibrozil are the preferred agents for the treatment of hypertriglyceridemia. Both compounds also have the favorable effect of raising HDL.
