Hypertriglyceridemia Treatment Assistant
Interactive, clinician-oriented recommendations based on fasting triglyceride level and clinical context
Patient Inputs
Use most recent fasting TG. For nonfasting 175–499 mg/dL, confirm with fasting per guidelines.
ASCVD risk drives statin use
Decision Support
Evidence notes
- Statins are first-line for ASCVD risk reduction in mild–moderate TG elevations; typical TG lowering ~10–30%.
- Icosapent ethyl (EPA 2 g BID) reduces CV events when TG 135–499 mg/dL on statins (e.g., REDUCE-IT).*
- Fibrates and/or prescription omega-3 fatty acids (2–4 g/day) are first-line when TG ≥500 mg/dL to mitigate pancreatitis risk.
- Very-low-fat diet and absolute alcohol avoidance are critical in severe hypertriglyceridemia.
- Screen and treat secondary causes (uncontrolled diabetes, hypothyroidism, CKD, medications).
*Outcome benefit demonstrated for EPA-only formulation; mixed results for mixed EPA/DHA products.
Quick Reference by Severity
150–199
- Lifestyle optimization (diet, exercise, weight loss)
- Review meds; moderate alcohol only
- Consider statin if ASCVD risk/LDL not at goal
200–499
- Statin = first-line (ASCVD prevention)
- EPA (icosapent ethyl) if high risk on statin
- Consider fenofibrate if persistent TG with low HDL
≥500
- Goal: prevent pancreatitis
- Very-low-fat diet; no alcohol
- Fenofibrate ± Rx omega-3; keep statin if ASCVD risk
≥1000
- Urgent management; consider admission if symptomatic
- Fibrate + high-dose Rx omega-3; very-low-fat diet
- If pancreatitis: insulin infusion ± plasmapheresis
This tool supports clinical decision-making; it does not replace clinician judgment or guideline review. Always individualize therapy based on comorbidities, drug interactions, renal/hepatic function, and patient preference.