Premature coronary heart disease is frequent. Type IV Hyperlipidemia is characterized by Hypertriglyceridemia. Defective lipolysis and an overproduction of VLDL are responsible. Triglyceride levels can be in the thousands. Eruptive Xanthomas and pancreatitis can occur.
Causes can be genetic or secondary to diabetes mellitus, obesity or alcohol consumption.
Diabetes mellitus, hypothyroidism, nephrotic syndrome, obstructive liver disease and certain pharmacologic agents. Birth control pills can cause hypertriglyceridemia in some women. The LRC trial used the drug Cholestyramine and the Helsinki study used the drug Gemfibrozil. Since these trials the more powerful HMG CoA Reductase inhibitors are now available making therapy more tolerable and effective. Regression of atherosclerotic lesions is seen in patients undergoing aggressive cholesterol lowering.