The authors postulate cardiovascular risk from increased triglyceride concentrations, which would actually be a reason for measuring this parameter (1). They do not, however, provide proof for their claim—the cited reference ([7] in the article) refers only to an association of hypertriglyceridemia and pancreatitis. The German College of General Practitioners and Family Physicians (Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin, DEGAM) in its guideline (2) does not make any mention of an increased cardiovascular risk—contrary to what was claimed in the article—but wrote: “The relevance/importance of triglycerides for the cardiovascular risk is the subject of controversy.”
Much space is taken up by the table showing the European recommendations for the treatment of dyslipidemias. Furthermore, the close relations between the European Society of Cardiology (ESC) and the pharmaceutical industry should raise substantial skepticism. The evidence levels falsely suggest a patient-relevant benefit. For fibrates, no lowering of cardiovascular mortality has been confirmed (3).
What remains unclear is whether the benefit of high-dose fish oil in the REDUCE-IT Study was not a function of the fact that in the control arm, the comparison substance used was mineral oil (4). Articles such as this one (1) substantially contribute to overdiagnosis and overtreatment.
Footnotes
Conflict of interest statement
The author is a member of the DEGAM working group for the guideline on cardiovascular prevention.
References
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