Triglyceride and Cardiovascular Disease

ABSTRACT

Hypercholesterolemia is a well-known risk factor for cardiovascular disease. However, cardiovascular risk still remains even after achieving target goals for total and low density lipoprotein (LDL) cholesterol. There is a controversy whether triglyceride (TG) is directly related with atherosclerosis and/or cardiovascular disease. Some studies demonstrate that hypertriglyceridemia is associated with cardiovascular disease, especially in patients with insulin resistance or metabolic syndrome. Triglyceride level below 100 mg/dL is considered as metabolically healthy state. Nonfasting TG level can be used to detect incident cardiovascular disease. Fasting lipid panel should be checked if nonfasting TG level is equal or greater than 200 mg/dL. Target goals of TG are <200 mg/dL in nonfasting state, and <150 mg/dL (normal) or <100 mg/dL (optimal) in fasting state. Overall treatment of hypertriglyceridemia is intensive life style modification including reducing body weight, decreasing carbohydrate intake, increasing n-3 fatty acid intake, reducing alcohol intake, and increasing aerobic exercise. Pharmacological therapy focuses on reducing LDL-cholesterol with statin. Drug therapy for reducing TG seems to have less evidence of reducing cardiovascular events. If TG level is equal or higher than 500 mg/dL, TG lowering therapy is recommended in addition to life style modification to prevent pancreatitis.