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May 01, 2016

The Danger of High Triglycerides for People with Heart Disease

Study reconfirms the serious effect of elevated triglycerides on longevity.

People with heart disease should keep a close eye on triglyceride levels, based on a recent study that independently links even slightly elevated triglycerides to increased risk of death.

Published in Circulation: Cardiovascular Quality and Outcomes, this study investigated the health risks associated with high triglycerides. Triglycerides are a type of fat found in the blood, which are usually measured along with cholesterol levels. Many studies have linked high triglycerides to increased risk for heart disease and death, but the topic is highly controversial.

As experts explain, it’s difficult to separate the effects of cholesterol and triglycerides on health outcomes. And it’s unclear whether triglycerides require more focused attention, especially for patients already on cholesterol-lowering statins.

To help settle the debate, researchers analyzed data from a large study called the Bezafibrate Infarction Prevention (BIP) trial. Conducted in Israel, this study followed more than 15,300 patients with heart disease for 22 years. Upon enrollment, participants had their cholesterol and triglyceride levels tested, among other key health markers. For more than two decades, researchers used a national registry to track mortality data on study participants.

Based on fasting triglyceride levels, participants were divided into five groups, ranging from low to extremely high triglyceride levels. In general, triglycerides below 150 mg/dL are considered normal, while anything over 200 mg/dL is defined as high.

After 22 years of follow-up, researchers found that elevated triglycerides were independently associated with mortality risk in patients with heart disease.

After taking into account factors like age and sex, survival rates for participants with low triglycerides (under 100 mg/dL) was 41% after 22 years. In contrast, survival rates for normal to extremely high triglycerides ranged from 37%–25%. Compared to patients with low triglycerides, patients with the highest triglyceride levels (>500 mg/dL) had 68% greater risk of death over the 22 year span.

Based on findings, authors conclude that triglycerides alone have a big impact on mortality risk for patients with heart disease. However, experts are cautious in interpreting results. The BIP trial was first started in 1990, before statins were widely used. In fact, one of the most common statins called simvastatin wasn’t approved by the U.S. Food and Drug Administration until 1991. Authors report that more than 90% of all study participants were not on cholesterol-lowering statins at the start of the study.

Since statins help lower cholesterol and reduce risk for heart events, they may minimize the impact of triglycerides heart attack and death. According to experts, future research is needed to determine whether specific treatment is needed to target triglycerides.

Still, that doesn’t mean the link between triglycerides and heart health should be ignored. This study, along with many others, suggest that high triglycerides increase risk of death. It’s important that patients, including those without heart disease, have their numbers checked regularly. By managing risk factors like high cholesterol, high triglycerides and high blood pressure, patients can improve heart health and reduce risk for life-threatening heart events.

Questions for You to Consider

  • What are statins?
  • Statins are drugs used to lower cholesterol. They help lower low-density lipoprotein (LDL or “bad”) cholesterol and raise high-density lipoprotein (HDL or “good”) cholesterol, which can help prevent heart attack and stroke. Statins prevent your body from making new cholesterol and may help reduce the amount of plaque already built up on artery walls.
  • At what age should I worry about my cholesterol?
  • More than one-third of Americans have high cholesterol and risk for high cholesterol increases with age. However, high cholesterol can be a problem at any age. It’s estimated that 22% of adults in their 20s have high cholesterol and 62% of adults in their 50s have high cholesterol. It’s important to have cholesterol checked regularly and make healthy lifestyle choices like eating healthy and staying active, which help control cholesterol levels.

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