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Elevated Triglyceride levels are associated with increased risk for atherosclerotic disease and additional vascular risk factors such as obesity, hypertension and impaired glucose tolerance. To estimate the individual cardiovascular risk of a patient with elevated triglycerides LDL- and HDL-cholesterol levels, concomitant diseases, composition of triglyceride rich lipoproteins and a family history for premature coronary heart disease are important. Primary goals for the management of hypertriglyceridemia are a reduction of cardiovascular risk and prevention of triglyceride associated complications such as the chylomicronemia syndrome. The basis of treatment are lifestyle changes: dietary intervention, alcohol avoidance, regular physical activity, weight loss and smoking cessation to modify risk factors. If triglyceride levels can not be sufficiently reduced by lifestyle intervention pharmacotherapy (nicotinic acid, fibrates and omega-3-acid ethyl esters) is indicated. Beyond reduction of triglyceride levels optimization of non-HDL-cholesterol by statin treatment is warranted to reduce vascular risk., (© Georg Thieme Verlag KG Stuttgart · New York.)

We studied a 60-year-old male with idiopathic (primary) hemochromatosis and type III hyperlipoproteinemia. Periodical phlebotomy therapy could favourably influence the disease of iron metabolism as well as the familial lipoprotein disorder in addition to fenofibrate treatment. Idiopathic hemochromatosis as aggravating cause of type III hyperlipoproteinemia has not been reported yet.