guidelines of hypertriglyceridemia presentation

guidelines of hypertriglyceridemia presentation

1. MANAGEMENT GUIDELINES HYPERTRIGLYCERIDEMIA 1

2. DYSLIPIDEMIAS 2

3. 3 EPIDEMIOLOGY

4. LIPID PROFILE LEVELS 4

5. CLASSIFICATION 5

6. CLASSIFICATION 6

7. FREDRICKSON CLASSIFICATION 7

8. HYPERTRIGLYCERIDEMIA CLASSIFICATION: Normal:< 150mg/dl (<1.7mmol/L) Moderate :150-499 mg/dl(1.7-5.6mmol/L) Moderate to severe: 500-999 mg/dl(5.65-11.3 mmol/L) Severe: > 1000mg/dl( >11.3) 8

9. HYPERTRIGLYCERIDEMIA 9 < 150 150 - 499 500 - 999 > 1000

10. ETIOLOGY 10 1 2 3

11. ACQUIRED FACTORS 11

12. CLINICAL MANIFESTATIONS 12

13. BLOOD SPECIMEN 13

14. LIPID PROFILE Raised LDL-C Raised non HDL-C & apoprotein B Low HDL-C 14

15. ASSOCIATED CONDITIONS 15 PANCREATITIS : TG >500mg/dl recent history ASCVD: TG >150 mg/dl Insulin resistance Inflammation Prothrombotic states

16. MANAGEMENT OF LDL-C DESIRABLE LDL-C TARGETS 16

17. TREATMENT ALGORITHM LIFE STYLE MODIFICATIONS: Healthy eating patterns Regular exercise Adequate restorative sleep Avoid smoke, alcohol Stress management 17

18. PHARMACOTHERAPY 18

19. DAIGNOSIS & EVALUATION 19 INDICATIONS: screening for lipid disorders evaluation of xanthomas screening of family members acute pancreatitis monitoring treatment CRITERIA: fasting TG>150mg/dl ASSESS COMPLICATIONS GENETIC TESTING

20. MANAGEMENT 20 GOALS: Reducing risk of pancreatitis and ASCVD. General measures A ddress modifiable causes Lifestyle modification (diet, alcohol consumption) Pharmacological therapy

21. PHARMACOLOGIC THERAPY Assess risk of future ASCVD Initiate statin therapy Moderate HTG (150-499mg/dl with ASCVD or at inc. Risk) : Eicosapentanoic acid (EPA) Moderate to severe HTG( 500-999mg/dl with ASCVD or at inc risk): EPA + fibrates

22. 22 SEVERE HYPERTRIGLYCERIDEMIA

23. EMERGING & INVETSIGATIONAL THERAPIES ANGPL3 Inhibitors : inhibits both LPL & endothelial lipase Evinacumab Zodasiran Gene therapy 23

24. HYPERTRIGLYCERIDEMIA INDUCED PANCREATITIS 24

25. MANAGEMENT CONTD. 25

26. CONCLUSION Hypertriglyceridemia is a significant risk factor for CVD and pancreatitis. Lifestyle changes are the cornerstone of treatment. Pharmacologic therapy is added for moderate to severe cases. Genetic testing helps in familial cases. Long-term follow-up and patient education are essential for preventing complications." 26

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