Recommendations for Hypertriglyceridemia Referenced studies that support recommendations are summarized in Online Data Supplements 31 and 32. COR LOE Recommendations I B-NR In adults 20 years of age or older with moderate hypertriglyceridemia (fasting or to 5.6 mmol/L]), clinicians should address and treat lifestyle factors (obesity and metabolic syndrome), secondary factors (diabetes mellitus, chronic liver or kidney disease and/or nephrotic syndrome, hypothyroidism), and medications that increase triglycerides.S4.5.2-1 In terms of CAC burden, South Asian men were similar to non- Hispanic white men, but higher CAC when than blacks, Latinos, and Chinese Americans. South Asian women had similar CAC scores to whites and other racial/ethnic women, although CAC burden higher in older age.S4.5.1-31 CAC predicts similarly in whites and in those who identify as Hispanic/Latino. In MESA, CAC score was highest in white and Hispanic men, with blacks having significantly lower prevalence and severity of CAC. Risk factor differences in MESA between ethnicities did not fully explain variability in CAC. However, CAC predicted ASCVD events over and above traditional risk factors in all ethnicities.S4.5.1-32 Treatment Lifestyle counseling (use principles of Mediterranean and DASH diets) Use lifestyle counseling to recommend a hearthealthy diet consistent with racial/ethnic preferences to avoid weight gain and address BP and lipids. Use lifestyle counseling to recommend a hearthealthy diet consistent with racial/ ethnic preferences to avoid weight gain and address BP and lipids. Use lifestyle counseling to recommend a hearthealthy diet consistent with racial/ ethnic preferences to avoid weight gain and address BP and lipids. Asian and Hispanic/ Latino groups need to be disaggregated because of regional differences in lifestyle preferences. Challenge is to avoid increased sodium, sugar, and calories as groups acculturate. Intensity of statin therapy and response to LDL- Clowering Japanese patients may be sensitive to statin dosing. 