Clinical Review on Triglycerides

Ulrich Laufs; Klaus G. Parhofer; Henry N. Ginsberg; Robert A. Hegele


Eur Heart J. 2020;41(1):99-109c. 

In This Article

Abstract and Introduction


Hypertriglyceridaemia is a common clinical problem. Epidemiologic and genetic studies have established that triglyceride-rich lipoproteins (TRL) and their remnants as important contributors to ASCVD while severe hypertriglyceridaemia raises risk of pancreatitis. While low-density lipoprotein is the primary treatment target for lipid lowering therapy, secondary targets that reflect the contribution of TRL such as apoB and non-HDL-C are recommended in the current guidelines. Reduction of severely elevated triglycerides is important to avert or reduce the risk of pancreatitis. Here we discuss interventions for hypertriglyceridaemia, including diet and lifestyle, established treatments such as fibrates and omega-3 fatty acid preparations and emerging therapies, including various biological agents.


Recent epidemiologic and genetic studies establish triglyceride (TG)-rich lipoproteins (TRL) and their remnants as important contributors to atherosclerotic cardiovascular disease (ASCVD). In addition, hypertriglyceridaemia (HTG) is a frequent cause of pancreatitis. This review article summarizes the current understanding of the TG metabolism from a clinical perspective, the current data on TRL for risk stratification and as treatment targets and discusses established and emerging treatment strategies.