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REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #11 2026

Forest plot of the prevalence rates of unspecified/mixed primary or secondary sHTG defined as
TG >880 or >886 mg/dL (>10 mmol/L), stratified by region (n = 5). Dyslipidaemia

CI, confidence interval; n, number of cases; N, sample size; sHTG, severe hypertriglyceridaemia; TG, triglycerides; US, United States.

As expected, when higher thresholds were applied, prevalence estimates dropped drastically. For instance, at a TG threshold of >886mg/
dL, the pooled overall prevalence was 1:526 (0.19%). A similar pattern was seen when TG thresholds were increased to >1000 mg/dL.

Data on the incidence of sHTG were extremely limited, with only three studies reporting incidence for different types of sHTG. One US
study reported the incidence rate of primary sHTG (TG >500 mg/dL) from 1998 and 2015, as an estimate of 24 per 100,000 person-
years. A Canadian study reported cumulative incidence rates
of 1:400 adults (250 per 100,000 person-years) for TG levels CLINICAL PEARLS FROM THE FACULTY
between 886 and 1771 mg/dL and 1:2500 adults (40 per 100,000
person-years) for TG levels >1771 mg/dL over a five-year period
(from 2010–2015).

The authors concluded that standardising TG thresholds,
terminology, and measurement conditions is crucial to accurately
estimate the global burden of the disease and properly identify
high-risk patients. By highlighting the variations in diagnostic
approaches and TG thresholds, the authors argued that
establishing a unified, standard definition is essential for
accurate diagnosis, equitable treatment access, and precise
epidemiological data.
WATCH
PROF. MARCIN WELNICKI DISCUSS
CLICK HERE THE CLINICAL RELEVANCE OF THIS
FOR THE LINK TO FULL ARTICLE ARTICLE.

Very high prevalence of nonoptimally controlled traditional risk factors at the onset
of cardiovascular disease.

Lee H, et al. J Am Coll Cardiol. 2025 Oct 7;86(14):1017-1029.

Traditional cardiovascular disease (CVD) risk factors (hypertension, high cholesterol, diabetes, and tobacco use) have been the
primary focus of prevention efforts for decades. Recently, large cohort studies have emphasised that the optimal (i.e., very low-risk)
levels for these risk factors are much lower than the standard thresholds used to prescribe treatments in clinical practice. Despite the
well-established role of these risk factors, recent medical literature has claimed that a substantial and growing number of patients (up
to 27% in some reports) are experiencing coronary heart disease (CHD) without having any of the four standard modifiable CV risk

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