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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.

Author information

1
Division of Cardiology, Heart Disease Prevention Program, University of California, Irvine, CA, USA.
2
Medical Affairs, Amarin Pharm, Inc, Bedminster, NJ, USA.
3
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.
4
Division of Cardiology, Heart Disease Prevention Program, University of California, Irvine, CA, USA. Electronic address: ndwong@uci.edu.

Abstract

BACKGROUND:

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

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

Cardiovascular disease; Dyslipidemia; Epidemiology; Statins; Triglycerides

PMID:
30594443
DOI:
10.1016/j.jacl.2018.11.008

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