Hypertriglyceridemia niacin

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Hypertriglyceridemia Patient Information

Overview

Classification

Familial hyperchylomicronemia
Familial hypercholesterolemia
Familial combined hyperlipidemia
Dysbetalipoproteinemia
Primary hypertriglyceridemia
Mixed hyperlipoproteinemia

Differential Diagnosis

Screening

ACC/AHA Guideline Recommendations

Summary

Treatment

Major recommendations for statin therapy

Therapeutic response to statin therapy

Blood cholesterol LDL and non-HDL treatment goals

Treatment in heart failure and hemodialysis

Primary prevention

Secondary prevention

Intensity of statin therapy in primary and secondary prevention

Safety Recommendations

Guideline on Lifestyle Management

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]

Overview

Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the diet, as well as with niacin, fibrates and statins (three classes of drugs). Increased fish oil intake may substantially lower an individual's triglycerides.[1][2][3].

Supportive Trial Data

Study name Source & year Study question Study Design Study Population Time period Intervention Results Conclusions
The Coronary Drug Project [4] J Am Coll Cardiol, 1986 Assess the long-term efficacy and safety of five lipid-influencing drugs RCT 8,341 men aged 30 to 64 years with h/o ECG confirmed myocardial infarction 1966 and 1975 five lipid-influencing drugs 15% reduction in the risk of MI among men with hypercholesterolemia and decreased total mortality by 10% at 15 years of follow up Favorable effect of niacin in decreasing non-fatal reinfarction (late benefit)
Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2 [5] Circulation, 2004 Assess the long-term efficacy and safety of five lipid-influencing drugs Double-blind randomized placebo-controlled study 167 patients (mean age 67 years), h/o coronary heart disease, low HDL(<45 mg/dL) 1 year Once-daily extended-release niacin (1000 mg) added to background statin therapy Increase in HDL-C by 21% and unchanged mean CIMT in the niacin group after 12 months Decreases progression of carotid artery disease in patients with atherosclerosis and statin therapy

References

  1. "Lipids Online Slides: hypertriglyceridemia, ICAM-1, fish oil, E-selectin".
  2. Terres W, Beil U, Reimann B, Tiede S, Bleifeld W (1991). "[Low-dose fish oil in primary hypertriglyceridemia. A randomized placebo-controlled study]". Zeitschrift für Kardiologie (in German). 80 (1): 20–4. PMID 2035283.
  3. "Fish oils in hypertriglyceridemia - Fish Oils Revisited Nutrition Research Newsletter - Find Articles".
  4. Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ; et al. (1986). "Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin". J Am Coll Cardiol. 8 (6): 1245–55. PMID 3782631.
  5. Taylor AJ, Sullenberger LE, Lee HJ, Lee JK, Grace KA (2004). "Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2: a double-blind, placebo-controlled study of extended-release niacin on atherosclerosis progression in secondary prevention patients treated with statins". Circulation. 110 (23): 3512–7. doi:10.1161/01.CIR.0000148955.19792.8D. PMID 15537681.


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