Hypertriglyceridemia and its pharmacologic treatment among US adults--invited commentary.

BACKGROUND Increasing evidence supports triglyceride (TG) concentration as a risk factor for cardiovascular disease. The prevalence of hypertriglyceridemia during a period of rising prevalence of obesity and its pharmacological treatment among US adults are poorly understood. METHODS We examined data for 5610 participants 20 years or older from the National Health and Nutrition Examination Surveys from 1999 to 2004. RESULTS The unadjusted prevalence (percentage [SE]) of a TG concentration of 150 mg/dL or higher (to convert triglycerides to millimoles per liter, multiply by 0.0113) was 33.1% (0.8%); a TG concentration of 200 mg/dL or higher, 17.9% (0.7%), a TG concentration of 500 mg/dL or higher, 1.7% (0.2%), and a TG concentration of 1000 mg/dL or higher, 0.4% (0.1%). Overall, 1.3% (0.2%) of participants used 1 of 3 prescription medications indicated to treat hypertriglyceridemia (ie, fenofibrate, gemfibrozil, or niacin); this percentage was 2.6% (0.4%) among participants with a TG concentration of 150 mg/dL or higher and 3.6% (0.7%) among participants with a TG concentration of 200 mg/dL or higher. CONCLUSIONS Among US adults, hypertriglyceridemia is common. Until the benefits of treating hypertriglyceridemia that is not characterized by extreme elevations of TG concentration with medications are incontrovertible, therapeutic lifestyle change remains the preferred treatment.