5th February 2024

Treatment options

Lifestyle modification

• Decrease the intake of saturated fatty acids
• It has a considerably more significant effect on hypertriglyceridemia
• Strict limitations on alcohol consumption
• Reduction in the intake of rapidly resorbed carbohydrates
• Physical activity
• Mediterranean diet with additional olive oil or nuts

Statin

• It can be administered if lifestyle modification alone does not meet the target LDL cholesterol level.
• If, after 4-6 weeks of treatment, the target LDL cholesterol level still needs to be attained, the statin dose can be adjusted accordingly.
• Lifestyle modification and statin treatment should be initiated simultaneously in patients at high or very high risk of coronary events.
• Statins are generally of little use in isolated hypertriglyceridemia, as LDL cholesterol is often already very low at the outset. 

Ezetimibe

• If statin alone fails to achieve the target LDL cholesterol concentration, ezetimibe should be added.
• If there is mixed hyperlipoproteinemia, statin should perhaps be prescribed with ezetimibe to achieve the primary treatment goal of regulating LDL cholesterol.

Fibrates

• If the triglyceride level stays above 400mg/dL despite lifestyle modification, a fibrate can be given, with the best option seeming to be with fenofibrate.

Omega-3 fatty acids

• As monotherapy, there is a reduction in cardiovascular events, but no strong evidence of improved outcomes when used in combination with statins.