Severe hypertriglyceridemia. Clinical characteristics and therapeutic management

Abstract Introduction The therapeutic management of severe hypertriglyceridaemia represents a clinical challenge. Objectives The objectives of this study were (1) to identify the clinical characteristics of patients with severe hypertriglyceridaemia, and (2) to analyse the treatment established by the physicians in each case. Methods A cross-sectional study was carried out using the computerised medical records of all patients >18 years of age with a blood triglyceride level ≥1000 mg/dL between 1 January 2011 and 31 December 2016. Clinical and laboratory variables were collected. The behaviour of the physicians in the 6 months after the lipid finding was analysed. Results A total of 420 patients were included (mean age 49.1 ± 11.4 years, males 78.8%). The median of triglycerides was 1329 mg/dL (interquartile range 1174–1658). No secondary causes were found in 34.1% of the patients. The most frequent secondary causes were obesity (38.6%) and diabetes (28.1%). Physical activity was recommended and a nutritionist was referred to in 49.1% and 44.2% of the patients, respectively. Secondary causes were identified and attempts were made to correct them in 40.7% of cases. The most indicated pharmacological treatments were fenofibrate 200 mg/day (26.5%) and gemfibrozil 900 mg/day (19.3%). Few patients received the indication of omega 3 fatty acids or niacin. Conclusion This study showed, for the first time in our country, the characteristics of a population with severe hypertriglyceridaemia. The therapeutic measures instituted by the physicians were insufficient. Knowing the characteristics in this particular clinical scenario could improve the current approach of these patients.