Moderate Hypertriglyceridemia Prevention Of Cardiovascular Disease
In the era of statin therapy, it is uncertain whether lowering TG levels in patients on statin therapy will further reduce cardiovascular events. As discussed in detail in the sections on individual drugs, the studies carried out so far have not shown that adding niacin or fibrates to statin therapy is beneficial with regards to cardiovascular disease. As also discussed, the available studies have major limitations because many of the patients in these outcome studies did not have substantial elevations in TGs and therefore the issue is an open question that requires additional studies. Notably, the REDUCE-IT trial, which tested the effect of high dose EPA in patients with elevated TG levels and the JELIS trial which tested the effect of EPA 1.8 grams per day in patients with high cholesterol levels demonstrated a reduction in cardiovascular events. However, in both of these trials the decrease in cardiovascular events was considerably greater than one would expect based on the reduction in TG levels suggesting that the decrease in cardiovascular events was not solely due to lowering TG levels and that other effects of EPA likely played a role.
When To Contact A Doctor
While high triglyceride levels may not usually cause symptoms, anyone who is uncertain or concerned about their triglyceride levels should consult a doctor.
Additionally, any adult who has not had a lipid profile test in the last 46 years should speak with a doctor about their cardiovascular risk factors and possible need for a test. Catching elevated levels of health markers, such as triglycerides or cholesterol, at an early stage may help a person make changes earlier to address the underlying issue.
How Can I Prevent Hypertriglyceridemia
Some causes cant be changed . But theres still a lot you can do in your daily life to prevent hypertriglyceridemia. Here are some steps you can take to help keep your numbers in the healthy range:
- Reduce sugar and refined carbohydrates.
Ask your healthcare provider for resources to help you manage your triglycerides.
Read Also: What Is The Difference Between Non Hdl And Ldl Cholesterol
Cholesterol And High Bp Run Together
It is important to note that high cholesterol and high blood pressure tend to run together, said Dr. Kirley. One doesnt necessarily cause the other, but its very common to see both in an individual.
And certainly, both of them contribute to raising somebodys risk for heart attack and stroke, she added, noting that the interventions to helpthings like more physical activity and nutritioncan impact both your blood pressure and your cholesterol.
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Truths About Statins And High Cholesterol
For every drop of scientific evidence that statins are safe and effective, there is a tidal wave of misinformation. Our patients are concerned about statin side effects theyve heard about from family or friends, or read about on the Internet.
Statins are the gold-standard for high cholesterol treatment. Theyre a powerful medication, and theyve been proven to save the lives of many men and women living with or having a high risk of heart attack or stroke.
But if statins are so effective, why are some people afraid to take them?
As with any medication, there are risks associated with taking statins, but the benefits far outweigh the risks for the vast majority of high-risk patients.
In an effort to put statin side effects into context and provide honest, scientific answers about statins and their use, weve put together a list of common questions our patients ask us:
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Best Medication For High Triglycerides
Triglycerides are the types of fat in the blood, which can increase the chances of having cardiovascular diseases. If you eat too much and take more calories than you need, the body transforms redundant calories into triglycerides.
The level of the triglycerides can be determined with a simple blood test. The blood test will include the cholesterol level as well. The difference between triglycerides and cholesterol is that triglycerides supply the body with energy and cholesterol is responsible for particular hormones and cells.
Drugs That Work In Your Intestines
What they are: Your doctor may call these âbile acid resinâ drugs or âbile acid sequestrants.â The work inside your intestines. They attach to bile from the liver and keep it from being absorbed back into your blood. Bile is made largely from cholesterol, so these drugs whittle down the bodyâs supply of cholesterol.
Examples include:
A different type of drug, ezetimibe , lowers âbadâ LDL cholesterol by blocking cholesterol absorption in your small intestine. Studies have found that in people who have had a heart attack, it can make a small cut in the risk of heart âevents,â such as another heart attack, when you also take a statin.
Side effects: For bile acid drugs, the most common side effects are constipation, gas, and upset stomach. For ezetimibe, the most common ones include muscle or back pain, diarrhea, and abdominal pain.
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Mechanisms Accounting For The Volanesorsen Induced Lipid Effects
Volanesorsen binds to apo C-III mRNA leading to increased degradation and thereby inhibits the hepatic synthesis of apo C-III protein resulting in a reduction in plasma apo C-III levels . Apo C-III has a number of important effects on the metabolism of TG rich lipoproteins . Apo C-III is an inhibitor of LPL and therefore decreasing apo C-III levels will enhance LPL activity. In patients with FCS this will not be important because patients with this disorder have defects in components of the LPL complex that result in the inability to increase LPL activity. Studies have shown that apo C-III stimulates the production and secretion of VLDL by the liver. This effect is also not likely to be of primary importance in patients with FCS as the very high TG levels are primarily due to chylomicrons and not VLDL. Whether apo C-III regulates chylomicron secretion by the intestine is unknown. Finally, and most importantly, Apo C-III inhibits the binding of TG rich lipoproteins to hepatic LDL receptors and LDL receptorrelated protein 1 decreasing the clearance of TG rich lipoprotein particles. A decrease in apo C-III will accelerate the clearance of TG rich lipoproteins, which likely accounts for the ability of volanesorsen to decrease TG levels in patients with FCS.
Based On The Gathered Results From The National Health And Nutrition Examination Survey From 2001
Although this was lower than the 33.3% prevalence in 2001-2004, it is still alarming given the current lifestyle of Americans which involves consumption of mostly processed and fast foods, and a sedentary lifestyle that contributes to increased prevalence of obesity.
Increased triglyceride levels are said to be related to cardiovascular diseases such as heart attack, heart failure, and stroke. And according to the Harvard Medical School, having high triglyceride levels may be an indication of a metabolic syndrome such as diabetes and pancreatitis.
Because of the complications associated with high triglycerides, it is recommended that those with high triglyceride levels engage in beneficial lifestyles such as increasing physical activities, losing weight, quitting smoking, and having a balanced diet.
However, it is difficult to monitor if you have high triglyceride levels because having this condition does not entail visible and characteristic symptoms. There are no recorded symptoms specific for having high triglycerides alone. The only way to know if you have high triglycerides is through a blood test that will assess your lipid profile.
Now, you may have already started wondering about what triglycerides are exactly? And how does it affect your overall condition? These questions will be answered throughout this guide. But to give you a hint: it is a type of lipid that can be found in our bodies performing an array of functions.
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Possible New Treatment For High Triglycerides
In the report in The New England Journal of Medicine, an international team of researchers describe a new therapy for high triglycerides. It involves a weekly injection of “antisense oligonucleotides” , pieces of DNA that short-circuit the livers production of triglycerides. The new report shows that ASOs can reduce triglyceride levels by as much as 70%.
Keep in mind that this was a phase 2 trial, which is designed to test whether a drug does what it is supposed to do . Larger, longer-term studies will be needed to see whether ASOs actually reduce the risk of heart disease, and what sorts of side effects they cause.
Many experimental medications that sparkle in early testing never become FDA-approved drugs. We wont know for several years whether ASOs will become available for individuals with high triglycerides.
Strophanthus Hispidus: For Reducing Extreme Effects Of High Cholesterol
Strophanthus Hispidus is an excellent natural medicine for reducing the extreme effects of high cholesterol levels in blood. It is very efficient and safe remedy which can be used in old age to tone up the weak heart muscles. It also has the capacity to drain off the dropsical affections that have occurred from extreme effects on heart due to high cholesterol deposits. The heart affections that have resulted as a combined effect of tobacco smoking and high cholesterol levels also come under this medicine. The other symptoms that guide towards the use of Strophanthus Hispidus are excessive palpitations, cardiac pain and breathlessness.
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Medications For High Triglycerides
If diet, exercise, and other lifestyle changes are not sufficiently reducing your triglycerides or your doctor feels your numbers are too high to address the problem with lifestyle interventions alone, they may recommend medication. Some common drugs prescribed to lower triglycerides include:
Statins Statins are appropriate as a cornerstone treatment for moderate to severely high triglyceride levels, according to the AHA/ACC guideline. These prescription drugs help prevent cholesterol from forming in the liver, lower LDL cholesterol and triglycerides, and raise HDL cholesterol, notes the AHA.
Omega-3 fatty acids These essential nutrients are found in fish, flaxseed, and other foods and in fish oil supplements, according to the National Institutes of Health Office of Dietary Supplements . The three main omega-3 fatty acids are alpha-linolenic acid , which is mainly found in plant oils, such as flaxseed and canola, and eicosapentaenoic acid and docosahexaenoic acid , which are found in fish and other seafood.
According to the ODS, many studies have shown that eating fish and seafood rich in omega-3s may help you keep your heart healthy and reduce your risk of heart disease. And boosting your EPA and DHA intake through foods and supplements can help lower your triglycerides.
Moderate Hypertriglyceridemia Prevention Of Cardiovascular Disease
In the era of statin therapy, it is uncertain whether lowering TG levels in patients on statin therapy will further reduce cardiovascular events. As discussed in detail in the sections on individual drugs, the studies carried out so far have not shown that adding niacin or fibrates to statin therapy is beneficial with regards to cardiovascular disease. As also discussed, the available studies have major limitations because many of the patients in these outcome studies did not have substantial elevations in TGs and therefore the issue is an open question that requires additional studies. Notably, the REDUCE-IT trial, which tested the effect of high dose EPA in patients with elevated TG levels and the JELIS trial which tested the effect of EPA 1.8 grams per day in patients with high cholesterol levels demonstrated a reduction in cardiovascular events. However, in both of these trials the decrease in cardiovascular events was considerably greater than one would expect based on the reduction in TG levels suggesting that the decrease in cardiovascular events was not solely due to lowering TG levels and that other effects of EPA likely played a role.
Read Also: Low Hdl And High Triglycerides
Drug Treatment Of Hypertriglyceridemia
The primary goal of pharmacotherapy is to reduce the incidence of cardiovascular events. Since studies have yielded unequivocal evidence that this reduction is achieved by lowering LDL-cholesterol levels, the first step in the management of patients with hypertriglyceridemia is to attempt to achieve the target LDL-cholesterol level . For this purpose, the strategies available for lowering LDL-cholesterol levels should be used, taking into account the overall risk . While the above-mentioned medications do not lower TG levels, they are indicated for the reduction of the cardiovascular risk. Bile acid sequestrants should not be used, as they can amplify any existing hypertriglyceridemia moreover, there is no evidence that cardiovascular events are reduced by a combination of bile acid sequestrants and statins .
Once the target LDL-cholesterol level has been achieved, and taking into account the overall risk, the decision has to be made whether a specific treatment for hypertriglyceridemia is required to achieve the non-HDL-cholesterol target . This decision is primarily based on the extent of hypertriglyceridemia and the absolute risk. Drug treatment should always be considered if the TG level is above 400 mg/dL , on the assumption that much higher levels will be reached intermittently .
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How Your Healthcare Provider Can Help
Your healthcare provider can help you get your triglyceride levels under control by ruling out possible causes like medications, thyroid issues, unmanaged diabetes and liver or kidney disease. They can then formulate an effective management plan with you. This might include medication and lifestyle changes like losing weight and eating smaller portions.
As mentioned before, a healthy, fiber-rich diet can help in the matter. Exercising regularly can also play a huge part in managing triglyceride levels. By cleaning up your existing routine, you could see changes in your triglyceride levels within a few months.
This article was adapted from Cleveland Clinic Heart Advisor.
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Is Milk Bad For Triglycerides
There were no significant differences between whole milk and skimmed milk in effects on total and LDL cholesterol, triacylglycerol, insulin, and glucose concentrations. Conclusions: Intake of 0.5 L/d of whole milk did not adversely affect fasting blood lipids, glucose, or insulin compared to skimmed milk.
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Dos And Donts In Managing High Triglycerides:
- DO exercise regularly.
- DO eat more fruits and vegetables and high-fiber foods such as oat bran. Cook with monounsaturated fatsolive, peanut, and canola oils.
- DO stop smoking.
- DO lose weight by changing your diet and doing aerobic exercise, such as walking, jogging, bicycling, or swimming. Exercise at least 30 minutes daily.
- DONT forget to treat other medical conditions such as diabetes and underactive thyroid.
- DONT drink more than two alcoholic drinks per day.
- DONT change your diet or medicines without your doctors approval.
Causes Of High Triglycerides
Now that we know what triglycerides are and who are more prone to have it. Lets discuss- what causes high triglycerides?.
There are multiple reasons for having high TGs levels in the blood. Here are some common causes of high TGs levels that you might already be aware of:
- High Fat Intake: As mentioned above, intake of oily, fried, and outside food gets converted to triglycerides and is stored in the fat cells. Regular intake will further result in increased levels of triglycerides.
- High Sugar and Refined Carbohydrate Intake: When we eat extra calories from sugar and refined food than the required amount, itll eventually get converted into triglycerides and with time its level will increase.
4. Lack of Physical Activity- Exercising has multiple benefits and one of them is improving high levels of triglycerides in our blood. Exercising will make us feel good while burning the extra fat cells and improving our metabolism.
Also Check: What Is The Best Medicine For High Triglycerides
Dangers Of High Triglycerides Levels
Also, high triglycerides may appear as a side effect of some medications such as contraception pills, diuretics, but blockers or steroids. High triglycerides usually mean that there are some other health issues which can lead to heart diseases. If you are overweight, have high blood pressure, high level of sugar in the blood and high cholesterol, beside high triglycerides, you should seek advice from your doctor and consider changing your lifestyle.
- Diet with high positive energy-intake balance and high fat or high glycaemic index.
- Increased alcohol consumption per day in men and women, respectively).
- Renal disease .
- Paraproteinaemia.
- Systemic lupus erythematosis.
- Medications, including corticosteroids, oral oestrogen, tamoxifen, thiazides, non-cardioselective beta-blockers and bile acid sequestrants, cyclophosphamide, L-asparaginase, protease inhibitors, and second-generation antipsychotic agents .