Patients with hypertriglyceridemia, or elevated triglycerides, who are at high risk for atherosclerotic cardiovascular disease (ASCVD) have the greatest risk of recurrent ASCVD events and, consequently, get the most benefit from further low-density lipoprotein cholesterol lowering with the addition of non-statin therapies. With the unique aspects of lifestyle intervention in patients with hypertriglyceridemia, and the evolving evidence for the benefits of cardiovascular risk reduction with a triglyceride risk-based approach, the writing committee for this 2021 Expert Consensus Decision Pathway aims to fill the gap in clinical care for the management of high-risk ASCVD patients with persistent hypertriglyceridemia and the incorporation of triglyceride non-statin therapies.
The consensus document emphasizes that lifestyle intervention, including adherence to a heart-healthy diet, regular physical activity, avoidance of tobacco products, limited alcohol consumption and maintenance of a healthy weight remains a critical component of ASCVD risk reduction, both before and while patients are using lipid-lowering medications. Recommendations are also provided for clinicians and patients regarding the use of statins and triglyceride non-statin therapies to reduce the risk of ASCVD in patients with persistent hypertriglyceridemia who have established ASCVD, diabetes mellitus, severe hypertriglyceridemia and other high-risk factors. In addition to cardiovascular professionals, registered dietitians are recommended for patients with persistent hypertriglyceridemia so they can receive individualized nutrition guidance.
The 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia will publish online in the Journal of the American College of Cardiology on Wednesday, July 28 at 2:00 p.m. ET.