ISSUE 1411
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Fibrates, niacin and fish oil are promoted for treatment of hypertriglyceridemia. HMG-CoA reductase inhibitors (statins) can lower elevated serum concentrations of triglycerides, but less so than fibrates, niacins or fish oil. Lifestyle changes such as weight reduction, exercise and decreasing alcohol intake can also lower serum triglyceride levels and should be tried first.1-3
TRIGLYCERIDE LEVELS AND RISK — Mildly (150-200 mg/dL) and moderately (200-500 mg/dL) increased levels of plasma triglycerides are associated with increased cardiovascular risk. This risk may not be due to triglycerides themselves, but rather to the cholesterol component of triglyceride-rich lipoproteins. Whether lowering triglyceride levels decreases the risk of cardiovascular disease is unclear. Triglyceride concentrations >1000 mg/dL are associated with lipemic plasma, eruptive xanthomas, hepatomegaly and
... more1. M Miller et al. Triglycerides and cardiovascular disease. A scientific statement from the American Heart Association. Circulation 2011; 123:2292.
2. Drugs for lipids. Treat Guidel Med Lett 2011; 9:13.
6. Fenofibric acid (Trilipix). Med Lett Drugs Ther 2009; 51:33.
8. E Bruckert et al. Meta-analysis of the effect of nicotinic acid alone or in combination on cardiovascular events and atherosclerosis. Atherosclerosis 2010; 210:353.
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