Therapy for hyperlipoproteinemia (hypertriglyceridemia) is based on the following pillars:
- Secondary prevention, that is, reduction of risk factors.
- Drug therapy
- Micronutrient therapy (vital substances)
- Further therapy (lifestyle change, etc.)
The treatment modality for hyperlipoproteinemia depends on the level of LDL measured and the risk factors that the individual has:
Risk group | LDL target value in mmol/l (mg/dl) | LDL value at which lifestyle changes should be made | LDL level at which drug therapy should be started |
10-year risk > 20% | < 2,6 (< 100) | ≥ 2,6 (≥ 100) | ≥ 3.4 (≥ 130)optimal from 2.6-3.3 (100-129) |
10-year risk 10-20 | < 3,4 (< 130) | ≥ 3,4 (≥ 130) | ≥ 3,4 (≥ 130) |
10-year risk 10% | < 3,4 (< 130) | ≥ 3,4 (≥ 130) | ≥ 4,1 (≥ 160) |
0-2 risk factors | < 4,1 (< 160) | ≥ 4,1 (≥ 160) | ≥ 4.9 (≥ 190)optimal from 4.1-4.9 (160-189) |
The risk groups are composed as follows:
First, the individual risk factors are added together, and if more than two risk factors are present, a specific calculation pattern is used to calculate the various categories of 10-year risk of coronary heart disease – disease of the vessels supplying the heart.
Risk factors include:
- Alcohol consumption (woman: > 20 g/day; man > 30 g/day).
- Tobacco consumption
- Hypertension – high blood pressure above 140/90 mmHg or taking antihypertensives (medication for high blood pressure).
- Low HDL cholesterol – < 1.0 mmol/l (< 40 mg/dl).
- Diabetes mellitus
- Family history positive for early coronary heart disease – disease of the vessels supplying the heart – in male first-degree relatives < 55 years/ in female first-degree relatives < 65 years of age.
- Age – males ≥ 45 years, females ≥ 55 years.
- Obesity (obesity)
- Lack of exercise
- Eating habits
- Elevated laboratory values of
- Lipoprotein (a)
- Homocysteine
- Prothrombotic factors – coagulation
- Proinflammatory factors – signs of inflammation.
- Fasting glucose (blood glucose; BG)
Furthermore, the highest possible HDL level is also important for the prevention of serious cardiovascular disease. It should be > 1.0 mmol/l (> 46 mg/dl).
Triglyceride levels should be in the following range:
- < 1.7 mmol/l (< 150 mg/dl).