Hypertriglyceridemia: Understanding High Triglycerides and Heart Health
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Hypertriglyceridemia is a condition in which your triglyceride level is 150 mg/dL or higher; a normal adult level is below 150 mg/dL. [1] The body stores extra calories as triglycerides for energy, but too many in the blood can contribute to hardening of the arteries. [1] It is diagnosed with a lipid panel and is not the same as high cholesterol. [1]
What the research says
Lowering triglycerides with a prescription omega-3 reduced heart events. In 8,179 statin-treated patients with triglycerides of 135 to 499 mg/dL and heart disease or diabetes, icosapent ethyl (4 g per day) cut major cardiovascular events from 22.0% to 17.2% over a median of 4.9 years (hazard ratio 0.75) and cardiovascular death from 5.2% to 4.3%. Hospitalization for atrial fibrillation was higher with the drug (3.1% vs 2.1%) (Bhatt et al., New England Journal of Medicine, 2019) [2].
High triglycerides are linked to early artery disease even with normal LDL. Among 3,754 middle-aged people with low to moderate risk, triglycerides of 150 mg/dL or more were associated with subclinical atherosclerosis (odds ratio 1.35), including in people with normal LDL cholesterol (odds ratio 1.85), and with arterial inflammation (odds ratio 2.09) (Raposeiras-Roubin et al., Journal of the American College of Cardiology, 2021) [4].
Prescription omega-3s can lower very high triglycerides substantially. An American Heart Association advisory concluded that 4 g per day of EPA plus DHA reduces very high triglycerides by 30% or more, although it can raise LDL cholesterol, while EPA alone did not raise LDL cholesterol (Skulas-Ray et al., Circulation, 2019) [3].
Key Takeaways
Feature | Details |
Definition | Too many triglycerides (fats) in the blood: 150 mg/dL or higher. [1] |
Normal Level | Below 150 mg/dL in adults (below 100 mg/dL is ideal); below 90 mg/dL in children ages 10 to 19. [1] |
Common Causes | Alcohol, refined carbohydrates and sugar, saturated fat, inactivity, medical conditions, certain medicines, and genetics. [1] |
Prevalence | About 1 in 5 U.S. adults; about 42% of adults age 60 and older. [1] |
Main Risks | Atherosclerosis, heart attack and stroke; acute pancreatitis at 500 mg/dL or more. [1] |
Symptoms | Usually none. Very high levels can cause skin bumps called xanthomas. [1] |
Main Treatment | Lifestyle changes first, then medicines such as fibrates, prescription omega-3s, or statins, and treating underlying causes. [1] |
The Role of Triglycerides in the Body
Triglycerides are lipids that provide energy to your body. [1] You get some from foods such as butter and oils. [1] When you consume more calories than you need, your body converts them into triglycerides and stores them in fat cells. Hormones release them when you need energy between meals. If you regularly take in more calories than you burn, especially from sugars, refined carbohydrates, and alcohol, triglyceride levels can stay high. [1]
Understanding Triglyceride Levels
Triglycerides are measured in milligrams per deciliter (mg/dL) with a lipid panel. [1] Your provider may ask you to fast for 10 to 12 hours first. [1] Adult fasting levels are classified as follows:
Category | Triglyceride Level (mg/dL) |
Normal | Below 150 |
Borderline high | 150 to 199 |
High | 200 to 499 |
Very high (severe) | 500 or higher [1] |
For children and teens ages 10 to 19, a normal fasting level is below 90 mg/dL. [1]
Symptoms
Most people with hypertriglyceridemia have no symptoms. [1] People with severe hypertriglyceridemia may develop xanthomas, skin bumps that form when fats build up under the skin. [1] With very high triglycerides they usually appear suddenly as small yellow-red bumps on the buttocks, shoulders, elbows or knees. [1]
Causes of Hypertriglyceridemia
High triglycerides often result from several factors combined, such as a genetic disorder along with lifestyle habits. [1]
Lifestyle Factors
Medical Conditions
Kidney disease (see chronic kidney disease) and liver disease [1]
Metabolic syndrome, nephrotic syndrome, lupus, and rheumatoid arthritis [1]
Menopause and pregnancy, especially the third trimester [1]
Medications
Medicines that can raise triglycerides include second-generation antipsychotics such as clozapine and olanzapine, HIV protease inhibitors, non-selective beta-blockers, corticosteroids, cyclophosphamide, oral estrogen, tamoxifen, and thiazides. [1] Never stop a medicine without talking to your provider.
Genetic Lipid Disorders
Familial combined hyperlipidemia: High triglycerides, high LDL cholesterol, and low HDL cholesterol. [1]
Familial hypertriglyceridemia: High triglycerides. [1]
Familial dysbetalipoproteinemia: High triglycerides and high total cholesterol. [1]
Familial chylomicronemia syndrome: Triglycerides above 1,000 mg/dL. [1]
Risks and Complications
High triglycerides raise your risk of atherosclerosis, the buildup of fatty plaques in the arteries, and related heart disease. [1] This is especially dangerous when HDL ("good") cholesterol is low or LDL ("bad") cholesterol is high. [1] At 500 mg/dL or more, the risk of acute pancreatitis, a painful inflammation of the pancreas that needs medical care, increases. [1]
Diagnosis
Providers diagnose hypertriglyceridemia with a physical exam, a review of your family history, lifestyle, and medicines, and a lipid panel that measures triglycerides and cholesterol. [1]
Managing and Lowering Triglycerides
Treatment includes lifestyle changes, medicines, and managing underlying causes. [1] You may need one or more of these.
Lifestyle Changes
Avoid alcohol, or limit it to one drink per day for women and two for men. [1]
Cut refined carbohydrates and sugars. [1]
Eat more seafood, especially fish that contains omega-3 fatty acids. [1]
Replace saturated and trans fat with healthier fats. [1]
Exercise more often and lower calorie intake to lose excess weight. [1]
Medicines
Medicines are especially important for severe hypertriglyceridemia. [1] Your provider may prescribe:
Outlook and Prevention
Your outlook depends on the cause, your triglyceride level, and your other medical conditions. [1] Many people manage their levels by following a treatment plan. [1] Some causes, such as aging, cannot be changed, but you can help keep your levels in a healthy range by eating a heart-healthy diet, being active, keeping a healthy weight, limiting alcohol, and reducing sugar and refined carbohydrates. [1]
When to See a Healthcare Provider
Visit your provider for annual checkups and follow their advice on testing. [1] Call 911 or your local emergency number for symptoms of acute pancreatitis, heart attack, or stroke. [1]
Conclusion
Hypertriglyceridemia is common but important to manage. With a balanced diet, regular activity, treatment of underlying causes, and medicines when needed, most people can bring their levels down and protect their heart and pancreas.
Frequently Asked Questions
Are high triglycerides the same as high cholesterol?
No. Both are lipids that travel in the blood, but triglycerides provide energy while cholesterol is used to build cells and hormones. Many people have both, and the combination with low HDL or high LDL cholesterol is especially risky. [1]
Is hypertriglyceridemia serious?
It needs treatment, but it is usually not a medical emergency. [1] Lowering your numbers helps you avoid complications that affect the heart or pancreas. [1]
What level of triglycerides is dangerous?
Levels of 500 mg/dL or more are considered very high and raise the risk of acute pancreatitis. [1] Lower elevations still raise heart disease risk over time.
How common is it?
About 1 in 5 U.S. adults have elevated triglycerides, and the risk rises with age: about 42% of adults age 60 and older. [1]
Can I lower my triglycerides without medication?
Often yes. Weight loss, less sugar, refined carbohydrates and alcohol, and regular exercise can bring levels down. [1] Ask your provider whether you also need medicine.
Do I need to fast before the test?
Your provider may ask you to fast for 10 to 12 hours before the lipid panel and drink only water. [1] Follow their instructions.
Can alcohol raise triglycerides?
Yes. Drinking too much alcohol can raise triglycerides, and avoiding alcohol is part of the usual advice. [1] If you drink, the limit is one drink per day for women and two for men. [1]
Can stress cause high triglycerides?
Stress is not a recognized direct cause, but it can lead to habits, such as poor food choices and more alcohol, that raise triglycerides.
Does keto help with high triglycerides?
Some people see lower triglycerides on low-carbohydrate diets, but diets high in saturated fat can be a problem for others. Ask your provider or a dietitian before starting a restrictive diet.
Which medicines can raise triglycerides?
Corticosteroids, oral estrogen, thiazides, tamoxifen, non-selective beta-blockers, some antipsychotics, and HIV protease inhibitors, among others. [1] Never stop a medicine on your own.
Do high triglycerides cause symptoms?
Usually not. [1] Very high levels can cause xanthomas, small yellowish skin bumps, often on the buttocks, elbows or knees, and can lead to pancreatitis, which causes severe abdominal pain.
Are triglyceride targets different for children?
Yes. A normal fasting level in children and teens ages 10 to 19 is below 90 mg/dL. [1] Talk to your child's provider if it is high.
Is high triglycerides hereditary?
It can be. Inherited lipid disorders include familial combined hyperlipidemia, familial hypertriglyceridemia, and familial chylomicronemia syndrome, where levels exceed 1,000 mg/dL. [1]
How often should I have my triglycerides checked?
Ask your provider. Frequency depends on your levels and heart disease risk factors, and people with high levels usually need more frequent testing.
When should I go to the emergency room?
Seek emergency care for symptoms of acute pancreatitis, heart attack, or stroke, because high triglycerides raise the risk of these complications. [1]
Related Reading
Lipid Panel: What It Measures, Normal Cholesterol Levels and How to Prepare explains the blood test that measures cholesterol and triglycerides.
References
Cleveland Clinic. Hypertriglyceridemia. Cleveland Clinic. Last updated July 29, 2022. https://my.clevelandclinic.org/health/diseases/23942-hypertriglyceridemia
Bhatt DL, Steg PG, Miller M, et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. New England Journal of Medicine. 2019;380(1):11-22. PMID 30415628. https://doi.org/10.1056/NEJMoa1812792
Skulas-Ray AC, Wilson PWF, Harris WS, et al. Omega-3 fatty acids for the management of hypertriglyceridemia: a science advisory from the American Heart Association. Circulation. 2019;140(12):e673-e691. PMID 31422671. https://doi.org/10.1161/CIR.0000000000000709
Raposeiras-Roubin S, Rosselló X, Oliva B, et al. Triglycerides and residual atherosclerotic risk. Journal of the American College of Cardiology. 2021;77(24):3031-3041. PMID 34140107. https://doi.org/10.1016/j.jacc.2021.04.059
Disclaimer
This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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