What is the role of medications in the treatment of types IV and V hyperlipoproteinemia (HLP)?

Updated: Jun 27, 2019
  • Author: Henry J Rohrs, III, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

Children with a strong family history of premature cardiovascular disease are not infrequently referred to the authors for evaluation and treatment; their predominant laboratory findings include low HDL-C levels and hypertriglyceridemia. When the TG level is 300 mg/dL or higher and HDL-C levels are less than 35 mg/dL with a family history of premature cardiovascular disease, pharmacotherapy (eg, niacin or fibric acid derivatives) is considered based on professional opinion. Treatment suggestions for types IV HLP and type V HLP are outlined below.

  • TG level of 300-499 mg/dL: Encourage a healthy lifestyle and consider pharmacotherapy when HDL-C concentration is less than 35 mg/dL and the patient has a family history of premature cardiovascular or FCH.

  • TG level of 500-999 mg/dL: Encourage a healthy lifestyle and consider pharmacotherapy because of an increased risk of pancreatitis.

  • TG level of 1000 mg/dL or more: Encourage a healthy lifestyle and institute pharmacotherapy because of the increased risk of pancreatitis.


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