What is the role of statins in the treatment of hypertriglyceridemia (high triglyceride levels)?

Updated: Jul 23, 2021
  • Author: Mary Ellen T Sweeney, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitors (statins) are not the drugs of choice to treat dysbetalipoproteinemia, but their use may be necessary if the response to a fibrate and or niacin is inadequate. For patients with mixed hyperlipidemias (elevations of both LDL-c and triglycerides), a moderate dose of a HMG CoA reductase inhibitor may be appropriate if the amount of triglyceride lowering necessary is only about 20%. If a patient is taking gemfibrozil, the addition of a statin should prompt switching to fenofibrate, which has a lower risk of causing severe myopathy.

Maximum doses of the strongest statins, atorvastatin, simvastatin, or rosuvastatin (cerivastatin was recalled from US market on 8/8/01), lower triglycerides approximately 40%, but such doses are not appropriate unless the LDL-c is at least 30% above the desired level.


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