Hypertriglyceridämie: prognostische Bedeutung und Therapiemöglichkeiten

Elevated Triglyceride levels are associated with increased riskfor atherosclerotic disease and additional vascular risk factorssuch as obesity, hypertension and impaired glucose tolerance. Toestimate the individual cardiovascular risk of a patient with elevatedtriglycerides LDL- and HDL-cholesterol levels, concomitant diseases,composition of triglyceride rich lipoproteins and a family historyfor premature coronary heart disease are important. Primary goalsfor the management of hypertriglyceridemia are a reduction of cardiovascularrisk and prevention of triglyceride associated complications suchas the chylomicronemia syndrome. The basis of treatment are lifestyle changes:dietary intervention, alcohol avoidance, regular physical activity,weight loss and smoking cessation to modify risk factors. If triglyceridelevels can not be sufficiently reduced by lifestyle interventionpharmacotherapy (nicotinic acid, fibrates and omega-3-acid ethylesters) is indicated. Beyond reduction of triglyceride levels optimizationof non-HDL-cholesterol by statin treatment is warranted to reducevascular risk.