Effect Of Fibrates In Combination With Other Lipid Lowering Drugs On Lipid And Lipoprotein Levels
STATINS
Statins are the primary drugs used to treat most patients with dyslipidemia. Statins are very effective in lowering LDL-C levels but have only modest effects on TG and HDL-C levels. Therefore, it is appealing to add a fibrate to patients who on statin therapy have LDL-C levels at goal but still have elevated non-HDL-C and TG levels and decreased HDL-C levels. Therefore, there have been numerous studies examining the effect of the combination of statins and fibrates on lipid and lipoprotein levels. An example is the Safari Trial which compared the effect of simvastatin only vs. simvastatin + fenofibrate in patients with combined hyperlipidemia . The results of this trial are shown in . As anticipated, adding a fibrate results in a further lowering of LDL-C, non-HDL-C, and TG levels with a further increase in HDL-C.
What Can You Do At Home To Treat High Triglycerides
The main way to deal with high triglycerides is to eat better and get more exercise. Here are some guidelines to help you manage your level:
Moderate exercise: Try to exercise 5 or more days each week. Lack of movement makes it hard for your body to process blood sugar and triglycerides as it normally does. So itâs important for you to get up and get moving more each day. Skip the escalator or elevator and climb stairs. Get off the bus or subway one stop early and walk. Find activities you enjoy: Walk, swim, or ride a bike. Join a gym. Talk to your doctor before you begin any exercise plan.
Watch your weight: If youâre carrying extra pounds, losing 5% to 10% of your weight can lower triglycerides. People with a healthy weight are more likely to have normal levels. Belly fat is associated with higher numbers.
Eat less bad fat and carbs: Try to lower the saturated fat, trans fat, and cholesterol in your diet. Cutting back on carbohydrates will help, too. Foods high in saturated fat, such as red meat, boost levels. Butter and cheese contain these same triglyceride-boosting fats. Choose lean meats or protein alternatives, such as chicken and unprocessed turkey, that are lower in saturated fat.
Another healthy option: Make meatless meals. Vegetarian pastas, chilis, and stir-fries are a delicious alternative to meat dishes. Avoid dishes loaded with cream or cheese in favor of recipes that use vegetable or olive oil and feature plenty of vegetables.
Who Should Use Fibrates
Your healthcare provider may prescribe fibrates to reduce your triglycerides and/or raise your HDL cholesterol levels. Although triglycerides are associated with cardiovascular disease, it has not been consistently established that taking fibrates reduces the risk of a heart attack or stroke. Lowering triglycerides using fibrate medications is a key step in reducing the risk for pancreatitis.
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How To Lower Triglycerides Fast Without Medications
Unlike many illnesses, much of the treatment centered around how to lower triglycerides actually has a lot to do with lifestyle factors like diet and physical activity. In fact, moderate to slightly high levels of triglycerides may be managed in this way alone, without the use of prescription medications. Since what raises triglycerides in the first place is often the foods that we eat, it is not a wonder that a mere change in ingestibles can provide long term benefits in the form of lower triglycerides levels. And, the long term management of the amounts of these fats circulating in the blood can often be well managed with a diet to lower triglycerides combined with an increase in moderate exercise.
Fats are also best left alone as much as possible for anyone trying to stave off ever rising levels of the manufactured blood fats. As such, fried foods and those that contain trans fat or saturated fat should be eliminated from diets entirely. Not only does this decrease the likelihood that triglycerides will remain on the rise, a low fat diet also contributes to a reduced risk of obesity. Being overweight or obese is a major contributing factor to the increase of triglycerides in the blood, and adhering to a low fat diet can reduce this risk dramatically.
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And Limit Unhealthy Ones
Namely, trans fats or partially hydrogenated oils, which sometimes show up in baked goods, snack foods, fried foods, refrigerated dough , nondairy creamers, and margarines.
Eating these harmful fats can send your triglycerides up in just a few short weeks, not to mention raise your LDL cholesterol and lower your HDL cholesterol.
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Will A Keto Diet Lower Triglycerides And Cholesterol
No, keto diets have been shown to increase cholesterol levels. The Mediterranean diet, however, has been shown to lower cholesterol levels and reduce the risk of cardiac events.
The Mediterranean diet promotes eating vegetables, fruits, whole grains, and healthy fats daily eating fish, poultry, beans, and eggs weekly reducing portions of dairy and limiting red meat.
Top Foods To Help Lower Triglyceride Levels
Triglycerides are a type of fat found in your body. Elevated levels are linked to an increased risk of cardiovascular disease .
Diet plays a major role in the production of triglycerides in your body. Certain foods may even help lower your blood levels.
Here are 8 top foods that may help lower triglyceride levels.
5 ).
Daily intakes of at least 25 grams of soy protein were most effective at lowering these fats in the blood .
Soybeans, edamame, tofu, and tempeh are excellent sources of isoflavones, a health-promoting compound linked to reduced triglycerides, weight management, and improved menopause symptoms .
Fermented soy products like natto and tempeh have a higher nutritional value than unfermented soy. When used to replace sources of animal protein, they have a potent triglyceride-lowering effect .
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Preventing High Triglyceride Levels
- Shedding the extra pounds can go a long way in reducing your triglyceride levels. If you are overweight, losing 5% to 10% of your body weight will do wonders for your health in general and triglyceride levels in particular.
- Cut down on added sugar by avoiding sweets, sodas, and other sugary beverages.
- Substitute saturated fats with healthy polyunsaturated fats such as safflower, corn, and soybean oils or healthy monounsaturated fats such as canola and olive oils.
- Because the excess carbohydrate in your diet is what gets later converted into triglycerides, it is essential to follow a low-carbohydrate diet.
- Minimize alcohol consumption, because even a small amount can cause significant damage as far as triglyceride levels are concerned.
- Follow a disciplined and regular eating pattern, broken down into six small meals over the course of the day rather than 3 large meals.
Drink Apple Cider Vinegar With Honey
Apple cider vinegar also helps reduce triglycerides and cholesterol levels.
A 2008 study published in the Pakistan Journal of Biological Sciences found that apple cider vinegar helped improve serum lipid profile in both normal and diabetic rats by decreasing triglycerides and low-density lipoproteins while raising HDL levels.
You can also mix apple cider vinegar with fresh orange, apple, grape, or other fruit juices.
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Skip The Sweet Drinks
One of the easiest things you can do to lower your triglycerides is to cut out sweetened drinks. Sodas and other sugary drinks are packed with fructose, a known offender when it comes to boosting triglycerides. Drink no more than 36 ounces of sweet sippers per week — that means three 12-ounce cans of soda.
Effect Of Low Dose Omega
Initial studies of the effect of fish oil administration on cardiovascular outcomes were favorable, demonstrating a reduction in events including all-cause mortality. However, more recent studies have failed to confirm these favorable results. In these more recent studies the use of other drugs, such as statins, that reduce cardiovascular disease were more intensively utilized. The outcomes studies that will be described below were carried out with doses of EPA and DHA that are lower than the doses used to lower plasma TGs. We will limit our discussion to the administration of fish oil as a drug and not discuss diet studies, such as DART, which had patients increase fatty fish intake .
The above results indicate that low dose fish oil do not significantly and consistently reduce the risk of cardiovascular disease.
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Alternative Remedies For High Triglyceride Levels
Here are 10 home remedies to reduce your triglycerides.
Garlic is one of the best remedies to reduce triglycerides.
A 2016 study published in the Journal of Nutrition found that garlic supplements have the potential of lowering blood pressure in hypertensive individuals, stimulating the immune system and regulating slightly elevated cholesterol concentration.
Another 2006 study published in the Journal of Nutrition further highlighted the effectiveness of garlic compounds in suppressing low-density lipoprotein oxidation, which may be one of the mechanisms that make garlic contributive to better cardiovascular health. However, further studies are required to comprehensively validate this health-promoting attribute of garlic.
Do take note that raw garlic has a more profound effect than boiled garlic in controlling these parameters, given fresh garlic has lipid-lowering activity.
- Eat 2 to 3 raw garlic cloves on an empty stomach daily for a few months. You can also include fresh garlic in your salad dressings.
- Alternatively, take garlic supplements after consulting your doctor.
What Are Triglycerides And What Is Considered A Healthy Level
Triglycerides are sort of like cholesterol: Both are types of fat found in your blood. But while cholesterol is used to make cells and certain hormones, the job of triglycerides is to store unused calories to give your body energy between meals.
Triglycerides get stored after you eat. If you take in any calories that arent needed for energy right away, theyre converted into triglycerides and transferred to your fat cells for later use.
Eating more calories than you need on the reg can lead to high triglycerides over time, which can up your risk for heart disease. Triglycerides are usually measured along with cholesterol, and numbers over 150 mg/dL are usually considered high.
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Mechanism Accounting For The Omega
While not the primary mechanism for the decrease in plasma TGs, studies have shown that omega-3-fatty acids may increase the clearance of TG rich lipoproteins . Post heparin lipoprotein lipase activity is not increased by omega-3-fatty acid administration but the lipolytic activity of non-stimulated plasma is enhanced . Additionally, apolipoprotein C-III levels are decreased with omega-3-fatty acid administration which could also contribute to an increase in the clearance of TG rich lipoproteins .
The increase in LDL-C levels that occurs in patients with marked hypertriglyceridemia treated with omega-3-fatty acids is thought to be due to the enhanced conversion of VLDL to LDL .
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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Eating Reishi Mushroom Can Help
Reishi mushroom is beneficial to the cardiovascular system due to its high content of heart-saving substances including sterols, ganoderic acids, coumarin, mannitol, and polysaccharides.
According to a 2016 study published in PLOS One, reishi mushrooms, scientifically known as Ganoderma lucidum and originating in Mexico, were found to contain bioactive compounds that exhibit hypocholesterolemic properties and prebiotic effects.
The ganoderic acids in Reishi mushroom help lower triglyceride levels, remove excess cholesterol from the blood, lower blood pressure, reduce platelet stickiness, and even help correct arrhythmias.
For lowering triglycerides, you can take reishi mushroom extract. The appropriate dose depends on factors such as age and current health conditions, so consult your doctor first.
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What Qualifies As High Triglycerides
According to MedlinePlus , blood levels less than 150 mg/dL fall under the triglycerides normal range, while anything higherknown as hypertriglyceridemiacan increase risk for heart disease. Elevated triglycerides can also be a very early sign of diabetes, states Kristin Thomas, MD, a board-certified internist and co-founder of Foxhall Medicine in Washington, DC.
Extremely high triglyceridesblood levels over 500 mg/dLmay be due to a genetic disorder and can increase the risk of pancreatitis, along with heart disease, including atherosclerosis , Dr. Thomas, co-author of You Can Prevent A Stroke, explains. It can be seen alone or in association with many other conditions, as well, such as metabolic syndrome, hypothyroidism, fatty liver disease and kidney disease, Dr. Malaney says.
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Change Your Diet To Reduce Triglycerides
Follow these dietary guidelines to reduce your triglycerides:
- Choose unsaturated fats Reduce your intake of saturated fats by eating less red meat and less full-fat dairy.
- Reduce total fat intake Get no more than 30 percent of your calories from fat.
- Eat less sugar Cut down on table sugar, syrup, sweets, and sugary drinks.
- Go for complex carbohydrates Substitute whole grains for refined grains like white bread and white rice.
- Cut back on alcohol If you drink, talk to your doctor about safe amounts.
Effect Of Fibrates On Cardiovascular Outcomes
There have been a number of studies that have examined the effect of a variety of different fibrates on cardiovascular disease. We will describe the major studies below.
A separate meta-analysis has focused on the effect of fibrates on cardiovascular disease in patients with pre-existing disease . It included 13 trials involving a total of 16,112 participants. For the primary composite outcome of non-fatal stroke, non-fatal myocardial infarction, and vascular death, fibrate therapy significantly decreased risk by 12% 0.88, 95% 0.83 to 0.94). Fibrates were effective for preventing myocardial infarction . Fibrates were not effective in lowering all-cause mortality , death from vascular causes , or stroke events . Since clofibrate has been discontinued due to safety concerns, the data were reanalyzed excluding clofibrate trials. Without clofibrate, fibrates no longer significantly reduced the primary outcome but were still effective in preventing myocardial infarctions . Subgroup analyses showed the benefit of fibrates on the primary composite outcome to be consistent irrespective of age, gender, and diabetes mellitus.
SUMMARY OF OUTCOME STUDIES
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How Are Triglycerides Measured
Your doctor may give you a common test called a lipid panel. It checks for different types of cholesterol, including the levels of the “good” kind and the “bad” kind. The American Heart Association recommends that everyone 21 and older get a lipid panel at least every 5 years.
The levels are checked after an overnight fast. Fat from a recent meal can muddy the picture.
These tests are important because you rarely have any symptoms when your triglycerides are high, unlike with many other conditions.
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.
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Are High Triglycerides A Common Problem
Experts recommend you keep your triglycerides below 150 milligrams per deciliter. About one-quarter of the people in the United States have high triglycerides. These numbers have declined since 2001, probably because more people take statin drugs and fewer people smoke cigarettes.
The U.S. FDA’s ban on trans fats in food could be another reason triglyceride levels have dropped among Americans. Trans fats increase the levels of not only LDL cholesterol also called the “bad” cholesterol but also triglycerides.
Even though trans fats may be banned by the FDA, you should choose unsaturated fats over saturated ones.
What Causes High Triglycerides
Aside from consuming a high-fat and/or high-carb diet, other lifestyle factors can contribute to high triglycerides, specifically excess weight, lack of exercise, drinking too much alcohol and smoking. Dr. Malaney adds that it can also be a side effect of certain medications, such as some birth control pills, beta blockers, antipsychotics medications, and corticosteroids.
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A Warm Cup Of Cayenne Pepper Solution
Cayenne pepper, known for adding spicy heat to your foods, also helps lower triglycerides naturally. It contains an alkaloid compound, capsaicin, that helps reduce triglycerides and LDL cholesterol in obese individuals.
- Add a ½ to 1 teaspoon of cayenne pepper to 1 cup of hot water. Drink this solution twice daily for a few weeks.
- Another option is to take cayenne supplements. Consult your doctor for the proper dosage and its suitability for your case.
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