Suboptimal Triglyceride Levels Common Among US Adults

Researchers evaluated the prevalence of elevated triglyceride levels in adults with and without statin use and the related 10-year predicted risk for atherosclerotic cardiovascular disease.

In the United States, a quarter of adults have suboptimal triglyceride levels, including nearly a third of patients who receive statin therapy, according to results published in the Journal of Clinical Lipidology.

The results also predicted that within the next decade, 3.4 million atherosclerotic cardiovascular disease (ASCVD) events will occur among patients with triglyceride level ≥150 mg/dL.

The study included participants from the US National Health and Nutrition Examination Surveys from 2007 to 2014 who were ≥20 years old (N=9593). The researchers looked at the proportions of triglyceride categories (<150 mg/dL, 150-199 mg/dL, 200-499 mg/dL, and ≥500 mg/dL) according to statin use. They also analyzed the 10-year estimated ASCVD risk and number of events.

Among participants who did not receive statin therapy, 75.3% had triglyceride level <150 mg/dL, 12.8% had triglyceride level 150 to 199 mg/dL, and 11.9% had triglyceride level ≥200 mg/dL. Among participants who received statin therapy, 68.4% had triglyceride level <150 mg/dL, 16.2% had triglyceride level 150 to 199 mg/dL, and 15.4% had triglyceride level ≥200 mg/dL.

The results indicated that 27.7% of participants with low-density lipoprotein cholesterol levels (<100 mg/dL or <70 mg/dL for patients with ASCVD) had triglyceride level ≥150 mg/dL despite statin use.

The researchers found that the odds of triglyceride level ≥150 mg/dL among statin users was associated with older age, higher body mass index, lower high-density lipoprotein cholesterol level, higher low-density lipoprotein cholesterol level, and diabetes.

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Among statin users, the estimated mean 10-year ASCVD risk from triglyceride level <150 mg/dL to ≥500 mg/dL ranged from 11.3% to 19.1%. In those not taking statin drugs, mean 10-year ASCVD risk ranged from 6.0% to 15.6%.

“This may warrant a greater emphasis on appropriate nutritional and physical activity counseling and approaches to managing elevated and high triglyceride levels as well as newer therapies that may address [hypertriglyceridemia] beyond what statin therapy currently provides, especially for the large number of persons with moderately elevated triglyceride levels,” the researchers wrote.

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Fan W, Philip S, Granowitz C, Toth PP, Wong ND. Hypertriglyceridemia in statin-treated US adults: the National Health and Nutrition Examination Survey [published online December 1, 2018]. J Clin Lipidol. doi:10.1016/j.jacl.2018.11.008