{"id":4032,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/hypertriglyceridaemia\/"},"modified":"2025-06-12T13:18:23","modified_gmt":"2025-06-12T12:18:23","slug":"hypertriglyceridaemia","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/hypertensionandlipidservices\/hypertriglyceridaemia\/","title":{"rendered":"Hypertriglyceridaemia"},"content":{"rendered":"\n<h3 class=\"wp-block-heading\">Services<\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>Clinic<\/strong> <\/td><td><strong>Specialist advice contact details<\/strong> <\/td><\/tr><tr><td>Lipid Clinic, RIE <\/td><td><a href=\"mailto:RIE.LipidClinicAdvice@luht.scot.nhs.uk\" target=\"_blank\" rel=\"noreferrer noopener\">RIE.LipidClinicAdvice@luht.scot.nhs.uk<\/a> <\/td><\/tr><tr><td>Lipid clinic, SJH <\/td><td>Tel: 01506 523 841 <\/td><\/tr><tr><td>Lothian lipid guidelines<\/td><td><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/HP-LothianLipidGuidelines.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><span style=\"text-decoration:underline\">Lothian Lipid Guidelines.pdf<\/span><\/a><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/HP-LothianTGguidelines.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Lothian Hypertriglyceridaemia Guidelines (Confirmed May 2019).pdf<\/a> <br><\/h4>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Seek specialist advice:<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If TG &gt;10<\/li>\n\n\n\n<li>TG 5\u201310 in a high cardiovascular risk patient not responding to statin treatment<\/li>\n\n\n\n<li>Suspected familial hyperlipidaemia<\/li>\n\n\n\n<li>Patients with significant hyperlipidaemia that is proving difficult to manage in primary care<\/li>\n\n\n\n<li>Refer urgently to secondary care those with TG &gt;20 not caused by alcohol or poor glycaemic control<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Triglycerides (TG) (mmol\/L)<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Routinely measured as part of a full lipid profile to enable LDL calculation.<\/li>\n\n\n\n<li>TG testing in isolation is rarely indicated.<\/li>\n\n\n\n<li>Can be elevated on a non-fasting sample due to the presence of dietary TG, consider fasting sample.<\/li>\n\n\n\n<li>Very high TG levels e.g. &gt;10mmol\/L are associated with pancreatitis; increased morbidity and mortality independent of CVD risk.<\/li>\n\n\n\n<li>High TG are most commonly due to secondary causes e.g. poorly controlled diabetes mellitus, alcohol excess or medications.<\/li>\n\n\n\n<li>The relationship between TG and cardiovascular risk is unclear. Overall it is felt that raised TG still confer a small degree of additional risk.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Clinical assessment<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Examine for any skin changes suggestive of a primary hyperlipidaemia<\/li>\n\n\n\n<li>Check TFTs, fasting blood glucose (<a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Diabetes-diagnosis-Asymptomatic.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Diabetes-diagnosis-Asymptomatic.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">click here for more information on the diagnostic work-up for diabetes<\/a>), renal function, liver function, MCV and GGT<\/li>\n\n\n\n<li>\u2020 Consider any relevant secondary causes e.g. review medications<\/li>\n\n\n\n<li>Further tests as appropriate e.g. pregnancy test, urinalysis to check for proteinuria<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"\/files\/sites\/2\/Raised-TG.png\" alt=\"Raised TG.png\" \/><figcaption class=\"wp-element-caption\">Flowchart Copyright NHS Lothian<\/figcaption><\/figure>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Treat with a&nbsp;<a rel=\"noreferrer noopener\" href=\"http:\/\/www.ljf.scot.nhs.uk\/LothianJointFormularies\/Adult\/2.0\/2.12\/Pages\/default.aspx\" target=\"_blank\">statin<\/a>if at significant (based on usual criteria)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">\u2020 Secondary causes of raised TG<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Alcohol excess<\/li>\n\n\n\n<li>Hypothyroidism<\/li>\n\n\n\n<li>Nephrotic syndrome\/ renal disease<\/li>\n\n\n\n<li>Immunoglobulin excessDrugs (including thiazides, non-cardioselective beta blockers, oestrogens, tamoxifen, corticosteroids)<\/li>\n\n\n\n<li>Bulimia<\/li>\n\n\n\n<li>Pregnancy<\/li>\n\n\n\n<li>Obesity<\/li>\n\n\n\n<li>Insulin resistance<\/li>\n\n\n\n<li>Diabetes<\/li>\n\n\n\n<li>Metabolic syndrome<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">* Lifestyle advice<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Weight loss, if appropriate<\/li>\n\n\n\n<li>Reduce or abstain from alcohol<\/li>\n\n\n\n<li>Dietary modification:<br>reduce total calorie intake by minimizing intake of fats and carbohydrate<br>increase intake of fish, especially oily fish<\/li>\n\n\n\n<li>Smoking cessation (smoking independently increases TG levels)<\/li>\n\n\n\n<li>Increase physical activity<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>More information is available at the\u00a0University of Edinburgh\u00a0site\u00a0\u00a0<a href=\"https:\/\/bloodpressureclinic.ed.ac.uk\/home-blood-pressure-monitoring\">Home blood pressure monitoring | Lothian Hypertension and Lipid clinics<\/a> &amp; <a href=\"https:\/\/bloodpressureclinic.ed.ac.uk\/measuring-blood-pressure\">Measuring blood pressure | Lothian Hypertension and Lipid clinics<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Services Clinic Specialist advice contact details Lipid Clinic, RIE RIE.LipidClinicAdvice@luht.scot.nhs.uk Lipid clinic, SJH Tel: 01506 523 841 Lothian lipid guidelines Lothian Lipid Guidelines.pdf Lothian Hypertriglyceridaemia Guidelines (Confirmed May 2019).pdf<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4029,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[281],"class_list":["post-4032","page","type-page","status-publish","hentry","category-hypertriglyceridaemia"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/hypertensionandlipidservices\/hypertriglyceridaemia\/\" rel=\"tag\">Hypertriglyceridaemia<\/a>","rttpg_excerpt":"Services Clinic Specialist advice contact details Lipid Clinic, RIE RIE.LipidClinicAdvice@luht.scot.nhs.uk Lipid clinic, SJH Tel: 01506 523 841 Lothian lipid guidelines Lothian Lipid Guidelines.pdf Lothian Hypertriglyceridaemia Guidelines (Confirmed May 2019).pdf","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4032","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4032"}],"version-history":[{"count":11,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4032\/revisions"}],"predecessor-version":[{"id":24294,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4032\/revisions\/24294"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4029"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4032"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4032"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}