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Severe hypertriglyceridemia (sHTG) has many causes

For most people with sHTG, a combination of factors can affect the production and/or clearance 
of plasma triglycerides (TGs).1

Plasma levels of TG are largely determined by:1

  • The production of very low-density lipoproteins (VLDL) and chylomicrons, which carry most plasma TGs
  • The removal of TGs from the circulation by lipolysis

Therefore, elevated TG levels may arise from increased VLDL production, increased chylomicron production, and/or reduced clearance of these lipoproteins by lipolysis or the liver.  If TG levels exceed 500 mg/dL (sHTG), the dominant metabolic abnormality is reduced lipolysis of circulating VLDL and chylomicrons.1

Most cases of sHTG have a genetic component, but secondary factors usually contribute.23

In some cases, genetic factors may explain high TG levels that are refractory to lifestyle changes and guideline-directed therapy.4,12

Lifestyle and Medical Factors9,4,2

Medications9,4,2

Genetic Causes4

learn about the clinical presentation of shtg >

REFERENCES

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  2. Virani SS, Morris PB, Agarwala A, et al. 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2021.
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