Omega-3-acid Ethyl Esters (Lovaza) For Severe Hypertriglyceridemia

INTRODUCTION Hypertriglyceridemia is an independent risk factor for coronary heart disease (CHD), according to the guidelines from the Third Report of the National Cholesterol Education Program Expert Panel on the Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP ATP III). High triglyceride (TG) levels are frequently found in combination with insulin resistance, obesity, and low levels of high-density lipoproteincholesterol (HDL-C) in patients with the metabolic syndrome. Extremely high TG concentrations can cause a number of medical problems, including CHD and acute pancreatitis. The primary causes of hypertrigly ceridemia include cigarette smoking, very-high-carbohydrate diets, disease (i.e., diabetes, nephrotic syndrome), certain drugs (i.e., corticosteroids, protease inhibitors), and genetic factors. Excess acute alcohol intake can also raise TG levels, especially when alcohol is consumed with food. TG levels are classified as follows: normal (below 150 mg/dL), borderline–high (150–199 mg/dL), high (200–499 mg/ dL), or very high (500 mg/dL or more). Approximately five to six million people in the U.S. have TG levels exceeding 500 mg/dL. NCEP ATP III guidelines endorse pharmacological treatment of hypertriglyceridemia above this value. The underlying principles in treating very high TG levels are to prevent acute pancreatitis and CHD. Standard treatments include: 1