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Know your triglycerides: Here’s why

The level of triglycerides in the blood, like measurements of “bad” cholesterol, helps to gauge your risk for heart disease.

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High levels of these fatty particles in the blood means you may need to step up healthy lifestyle changes.

Do you know your LDL cholesterol level? Most men concerned with heart health probably do. Low-density lipoprotein (LDL), or “bad” cholesterol, invades the artery walls and causes atherosclerosis, the buildup of fatty deposits in arteries that leads to heart attacks and strokes. But LDL is not the only fatty substance, or lipid, in the blood that affects your cardiovascular risk.

“LDL is bad—that’s lipids 101,” says Dr. Linda Hemphill, a cholesterol specialist at Harvard-affiliated Massachusetts General Hospital. “But there are other things that contribute.”

The other bad guys in this story are triglycerides, fats that circulate in the blood after you eat. Unless triglycerides are extremely high, most men don’t need to take a medication to lower them. But a high number does send a signal that you need to step up efforts to maintain a healthy weight and diet.

How to lower your triglycerides

  • Lose weight if you are overweight.

  • Exercise regularly.

  • Reduce the refined carbohydrates you eat, such as white flour, rice, and sweets.

  • Limit alcohol to one or two standard drinks per day (5 ounces wine, 12 ounces beer, or 1.5 ounces spirits).

  • If your triglycerides are very high, try to reduce sources of saturated fats, such as red meat, butter, cheese, and fried foods. Replace these with unsaturated fats from plant oils and fish.

Triglyceride levels

Normal

Below 150 mg/dL

High normal

150-199 mg/dL

High

200-499 mg/dL

Very high

500 mg/dL or greater

Lipids and cardiovascular risk

Measuring triglycerides is part of the standard “lipid profile” men should have periodically. In fact, the triglyceride measurement is used to calculate your LDL, which explains why it’s necessary to fast before the test to get an accurate reading. Your profile will also measure high-density lipoprotein (HDL), the “good” cholesterol that removes LDL from the arteries and takes it to the liver for disposal.

Your doctor uses your LDL and HDL, along with other factors, to estimate the risk of heart attack and stroke. Keeping LDL in check—sometimes with the help of a cholesterol-lowering statin—lowers the risk.

Triglyceride levels above 150 milligrams per deciliter (mg/dL) are associated with a higher cardiovascular risk. Scientists don’t all agree on how or why high triglycerides may lead to clogged arteries. However, some think the process involves particles, called lipoproteins, that transport triglycerides through the blood.

Triglycerides are fat, so they can’t move freely through the watery bloodstream without being packaged as lipoproteins. As triglycerides rise, the body produces additional kinds of lipoproteins to carry the triglycerides around. “If the triglycerides are elevated, you are dealing with a whole spectrum of lipoproteins that could cause atherosclerosis,” Dr. Hemphill says.

When triglycerides are high, combining the levels of all the non-HDL cholesterol provides a more complete picture of cardiovascular risk. The math is simple: take the total cholesterol from your lipid results and subtract the HDL. The result represents all the stuff that can potentially contribute to clogging.

If your triglycerides are high

Research to date hasn’t conclusively shown that using medication to lower moderately high triglycerides (200 to 500 mg/dL) prevents heart attacks and strokes. Instead, your doctor will advise you to take some steps to help lower triglycerides as well as boost your general heart health. These include exercising more, losing weight if you are overweight, and improving your diet.

There are some exceptions. Men with known heart disease or risk factors for it, including diabetes, could take a statin drug if they are not already doing so. This lowers cardiovascular risk and reduces triglycerides, too.

If triglycerides rise above 500 mg/dL and you cannot lower them with lifestyle changes, your doctor will recommend medication. This is to prevent pancreatitis, a dangerous inflammation of the pancreas.

You may have heard that fish oil—either over-the-counter capsules or concentrated prescription versions—can help lower triglycerides. It does, but must be taken at high doses to have a significant effect on your triglyceride level. Also be aware that such high doses may lead to unpleasant side effects like stomach upset, belching, and a fishy taste in the mouth.

Posted by: Dr.Health

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