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Oct 07, 2019

Lowering Triglycerides to Reduce Heart Risks

Study confirms cardiovascular benefits of lowering triglycerides with therapies including an omega-3 fatty acid.

Published in the American Heart Association journal Circulation, this study analyzed data from 49 clinical trials that tested the impact of various cholesterol therapies on heart health. The goal of the analysis was to see how reducing triglycerides impacts risk for heart events like heart attack and stroke.

According to authors, triglycerides are usually included in cholesterol tests as a way to assess heart risks. However, triglycerides are not as aggressively treated as things like LDL (low-density lipoprotein) cholesterol, since the benefits of triglyceride therapy are unclear.

The recent analysis included 374,358 patients who were put on therapies known to reduce triglycerides, including statins, fibrates, niacin and omega-3 fatty acids. Participants’ average triglyceride level was 163 mg/dL, which is slightly higher than recommended goal of 150 mg/dL based on current guidelines.

During an average follow-up of 5 years, there were a total of 46,180 heart events among participants. However, researchers found that every 1 mmol/L reduction in triglycerides was associated with 8–21% lower risk of heart events, depending on the type of analysis.

Authors also found that for each 1 gram of EPA (eicosapentaenoic acid)—one form of omega-3 fatty acids—taken per day lowered risk for heart events by 7%. The health benefits of another type of omega-3 fatty acids called DHA (docosahexaenoic acid) were not significant.

The take-home message, according to authors, is that lowering triglycerides does, in fact, reduce risk for heart events. Findings also confirm the benefits of the omega-3 fatty acid, EPA, in reducing risk for heart events.

So why has there been uncertainty in the benefits of lowering triglycerides? The study showed that nearly all trials testing non-stain drugs didn’t include enough patients to detect a meaningful difference in outcomes. However, by combining findings from nearly 50 studies for this analysis, experts were able to get a more accurate picture of the effects of triglyceride-lowering therapies.

Of course, authors note that the impact of lowering triglycerides is not as significant as lowering LDL cholesterol, which doctors currently treat aggressively to reduce heart risks. However, heart disease is the leading cause of death among both men and women in the United States. Treating triglycerides, in addition to other types of cholesterol, could offer an important way to further reduce risk for life-threatening heart events.

Questions for You to Consider

  • 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.
  • What foods are highest in omega-3 fatty acids?

  • Flaxseed and flaxseed oil are foods containing the most omega-3 fatty acids, followed by certain fish, fish oils and nuts. Certain plants and spices are also high in omega-3 fatty acid, such as fresh basil, dried oregano and grape leaves. 

Infographic: Managing High Cholesterol


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