Severe hypertriglyceridemia. Clinical characteristics and therapeutic management

Clin Investig Arterioscler. 2018 Sep-Oct;30(5):217-223. doi: 10.1016/j.arteri.2018.03.005. Epub 2018 May 19.
[Article in English, Spanish]

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≥1,000mg/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 1,329mg/dL (interquartile range 1,174-1,658). 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 200mg/day (26.5%) and gemfibrozil 900mg/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.

Keywords: Diabetes; Hipertrigliceridemia; Hypertriglyceridaemia; Obesidad; Obesity; Tratamiento; Treatment.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Fatty Acids, Omega-3 / administration & dosage
  • Female
  • Fenofibrate / administration & dosage
  • Gemfibrozil / administration & dosage
  • Humans
  • Hypertriglyceridemia / etiology
  • Hypertriglyceridemia / physiopathology
  • Hypertriglyceridemia / therapy*
  • Hypolipidemic Agents / administration & dosage*
  • Lipids / blood*
  • Male
  • Middle Aged
  • Niacin / administration & dosage
  • Practice Patterns, Physicians' / standards
  • Severity of Illness Index
  • Triglycerides / blood*

Substances

  • Fatty Acids, Omega-3
  • Hypolipidemic Agents
  • Lipids
  • Triglycerides
  • Niacin
  • Gemfibrozil
  • Fenofibrate