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J Clin Lipidol. 2019 Jan - Feb;13(1):100-108. doi: 10.1016/j.jacl.2018.11.008. Epub 2018 Dec 1.

Hypertriglyceridemia in statin-treated US adults: the National Health and Nutrition Examination Survey.

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Division of Cardiology, Heart Disease Prevention Program, University of California, Irvine, CA, USA.
Medical Affairs, Amarin Pharm, Inc, Bedminster, NJ, USA.
Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Preventive Cardiology, CGH Medical Center, Sterling, IL, USA.
Division of Cardiology, Heart Disease Prevention Program, University of California, Irvine, CA, USA. Electronic address:



Statin therapy remains the primary treatment for mixed dyslipidemia, even with moderate triglyceride (TG) elevations.


We examined the prevalence of elevated TG levels in adults with and without statin use and the associated 10-year predicted atherosclerotic cardiovascular disease (ASCVD) risk.


We studied 9593 US adults aged ≥20 years (219.9 million projected) in the US National Health and Nutrition Examination Surveys, 2007 to 2014. We determined the proportions of TG categories (<150, 150-199, 200-499, and ≥500 mg/dL) according to statin use, as well as the 10-year estimated ASCVD risk and number of events.


Among those not taking statin therapy, the prevalence of TG < 150, 150 to 199, and ≥200 mg/dL was 75.3%, 12.8%, and 11.9%; among statin users, these proportions were 68.4%, 16.2%, and 15.4%, respectively. Among persons with low-density lipoprotein cholesterol <100 mg/dL (or <70 mg/dL in those with ASCVD), despite statin use, 27.7% had TG ≥ 150 mg/dL. The odds of TG ≥ 150 mg/dL in statin users was associated with greater age, higher body mass index, lower high-density lipoprotein cholesterol, higher low-density lipoprotein cholesterol, and diabetes. Estimated mean 10-year ASCVD risk from TG < 150 to ≥500 mg/dL, ranged from 11.3% to 19.1% in statin users and 6.0% to 15.6% in nonusers, with an overall 3.4 million ASCVD events expected in the next 10 years.


One-fourth of US adults overall, including nearly one-third of those on statin therapy, have suboptimal TG levels. More than 3 million ASCVD events are expected to occur over the next decade in those with TG ≥ 150 mg/dL, with approximately 1 million events expected in statin users.


Cardiovascular disease; Dyslipidemia; Epidemiology; Statins; Triglycerides


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