Prescribing Advice for GPs

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Triglyceride Factfile

The British Heart Foundation has published a Factfile focussing on Triglycerides.

This document discusses the relationship between triglyceride levels (TG levels) and cardiovascular disease (CVD). Although there is a positive correlation between TG levels and cardiovascular risk the relationship is weakened after correcting for other factors including total cholesterol, low-density lipoprotein, glucose and obesity.

Additionally, trials investigating TG lowering and CVD prevention are not conclusive; the only clear benefit is for gemfibrozil yet this benefit does not appear to relate to TG lowering!

It is suggested that secondary causes of high triglycerides should be identified and altered first, for example reducing alcohol intake and consuming a low fat diet. Statins remain the first line treatment for primary and secondary prevention of cardiovascular disease in combination with intensive diet and lifestyle measures.

Treatment combinations to achieve lower TG levels are supported by surrogate evidence only (e.g. carotid intima-medial thickness) and require careful safety monitoring for rhabdomyolysis. Isolated cases of elevated TG levels can be treated with fibrates and omega-3 fatty acids in severe cases.

Action: Clinicians who see patients with elevated levels of triglycerides will find this Factfile useful in guiding treatment decisions.

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