EVIDENCED-BASED CLINICAL MEDICINE

Hypertriglyceridemia is a commonly encountered lipid abnormality frequently associated with other lipid and metabolic derangements. The National Cholesterol Education Program recommends obtaining a fasting lipid panel in adults over the age of 20. The discovery of hypertriglyceridemia should prompt an investigation for secondary causes such as high fat diet, excessive alcohol intake, certain medica-tions, and medical conditions (eg, diabetes mellitus, hypothyroidism). In addition, patients should be evaluated for other components of the metabolic syndrome. These include abdominal obesity, insulin resistance, low high-density lipoprotein (HDL), high triglyceride, and hypertension. Hypertriglyceride-mia is classified as primary hypertriglyceridemia when there are no secondary causes identified. Pri-mary hypertriglyceridemia is the result of various genetic defects leading to disordered triglyceride me-tabolism. It is important to treat hypertriglyceridemia to prevent pancreatitis by reducing triglyceride levels to<500 mg/dL. Furthermore, lowering triglycerides while treating other dyslipidemias and com-ponents of the metabolic syndrome will reduce coronary events. However, it is controversial how much isolated hypertriglyceridemia correlates directly with coronary artery disease and further studies are needed to clarify whether treatment for this condition leads to meaningful clinical outcomes. Therapeu-tic lifestyle changes (TLC) are the first line of treatment for hypertriglyceridemia. These changes includ