More Than Half of U.S. Adults May Have High
Triglycerides, Few Follow Treatment
This blood fat, like cholesterol, can lead to heart
disease; ingested calories not used immediately by tissues are converted
to triglycerides
March
23, 2009 Most senior citizens know to watch their cholesterol, but
much less attention is paid to triglycerides, a fat in the blood stream
that can also lead to heart disease. A new study has found high
concentrations of theses blood fats are common among U.S. citizens.
"Increasing evidence supports triglyceride
concentration as a risk factor for cardiovascular disease," according to
a report in the March 23 issue of Archives of Internal Medicine,
one of the JAMA/Archives journals.
"If triglyceride concentrations are indeed a risk
factor for cardiovascular disease, then it becomes important to
establish the prevalence of hypertriglyceridemia (the resulting
condition) in the U.S. population and to learn about the degree of
pharmacologic management of this risk factor."
(Read
more about triglycerides below news report.)
Earl S. Ford, M.D., M.P.H., and colleagues at the
Centers for Disease Control and Prevention, Atlanta, examined data for
5,610 participants age 20 or older who participated in the National
Health and Nutrition Examination Surveys between 1999 and 2004.
The 2,837 men and 2,773 women were interviewed at
home and then invited to attend a mobile examination center, where they
answered additional questions, underwent examinations and provided blood
samples.
Following are the results as grouped by the levels
established by the 2001 National Cholesterol Education Program report:
● 33.1 percent of participants had a
triglyceride concentration of 150 milligrams per deciliter or higher
(between 150 and 199 milligrams per deciliter is defined as borderline
high),
● 17.9 percent had a concentration of 200
milligrams per deciliter or higher (defined as high),
● 1.7 percent had a concentration of 500
milligrams per deciliter or higher and
● 0.4 percent had a concentration of 1,000
milligrams per deciliter or higher.
Compared with those who did not have
hypertriglyceridemia, those who did were more likely to be older, be
white, have not pursued an education beyond high school, smoke, be
overweight or obese or have diabetes.
"An important approach to the patient with
hypertriglyceridemia is the implementation of non-pharmacological
interventions," the authors write.
"The high percentages of participants with a
triglyceride concentration of 200 milligrams per deciliter or higher who
were overweight or obese, who failed to engage in physical activity for
approximately 150 minutes per week or who smoked attest to the challenge
confronting health care providers in working with their patients to
implement therapeutic lifestyle changes."
Lifestyle changes are the preferred initial
treatment for hypertriglyceridemia, but physical inactivity, obesity and
other modifiable risk factors remain prevalent.
A total of 1.3 percent of participants used one of
three prescription medications (fenofibrate, gemfibrozil or niacin) that
treat hypertriglyceridemia, including 2.6 percent of those with a
concentration of 150 milligrams per deciliter or higher and 3.6 percent
of those with a concentration of 200 milligrams per deciliter or higher.
This may reflect uncertainty about the need to
treat this abnormality, the authors note.
The benefits of pharmacotherapy are clear for
patients with levels of 500 milligrams per deciliter or higher, who are
at risk for pancreatitis, but therapeutic lifestyle changes remain the
initial therapy of choice for those with levels between 200 and 500
milligrams per deciliter.
"As research clarifies uncertainties in the
relation between triglyceride concentration and cardiovascular disease,
guidelines to treat hypertriglyceridemia will likely be modified," they
conclude.
More About Triglycerides
By American Heart Association
What are triglycerides?
Triglycerides are the chemical form in which most
fat exists in food as well as in the body. They're also present in blood
plasma and, in association with cholesterol, form the plasma lipids.
Triglycerides in plasma are derived from fats eaten
in foods or made in the body from other energy sources like
carbohydrates. Calories ingested in a meal and not used immediately by
tissues are converted to triglycerides and transported to fat cells to
be stored. Hormones regulate the release of triglycerides from fat
tissue so they meet the body's needs for energy between meals.
How is an excess of triglycerides harmful?
Excess triglycerides in plasma is called
hypertriglyceridemia. It's linked to the occurrence of coronary artery
disease in some people. Elevated triglycerides may be a consequence of
other disease, such as untreated diabetes mellitus. Like cholesterol,
increases in triglyceride levels can be detected by plasma measurements.
These measurements should be made after an overnight food and alcohol
fast.
The National Cholesterol Education Program
guidelines for triglycerides are:
Normal
Less than 150 mg/dL
Borderline-high
150 to 199 mg/dL
High
200 to 499 mg/dL
Very high
500 mg/dL or higher
These are based on fasting plasma triglyceride levels.
AHA Recommendation Dietary treatment goals
Changes in lifestyle habits are the main therapy for
hypertriglyceridemia. These are the changes you need to make:
● If you're overweight, cut down on calories to
reach your ideal body weight. This includes all sources of calories,
from fats, proteins, carbohydrates and alcohol.
● Reduce the saturated fat, trans fat and
cholesterol content of your diet.
● Reduce your intake of alcohol considerably.
Even small amounts of alcohol can lead to large changes in plasma
triglyceride levels.
● Eat fruits, vegetables and nonfat or low-fat
dairy products most often.
● Get at least 30 minutes of moderate-intensity
physical activity on five or more days each week.
● People with high triglycerides may need to
substitute monounsaturated and polyunsaturated fats such as those found
in canola oil, olive oil or liquid margarine for saturated fats.
Substituting carbohydrates for fats may raise triglyceride levels and
may decrease HDL ("good") cholesterol in some people.
● Substitute fish high in omega-3 fatty acids
instead of meats high in saturated fat like hamburger. Fatty fish like
mackerel, lake trout, herring, sardines, albacore tuna and salmon are
high in omega-3 fatty acids.
Because other risk factors for coronary artery
disease multiply the hazard from hyperlipidemia, control high blood
pressure and avoid cigarette smoking. If drugs are used to treat
hypertriglyceridemia, dietary management is still important. Patients
should follow the specific plans laid out by their physicians and
nutritionists.
If you've been keeping an eye on your blood
pressure and cholesterol levels, there's something else you might need
to monitor: your triglycerides. Having a high level of triglycerides, a
type of fat in your blood, can increase your risk of heart disease. If
you didn't even realize you had triglycerides, relax. The same lifestyle
choices that promote overall health can help lower your triglycerides,
too.
What are triglycerides?
Triglycerides are a type of fat found in your
blood. When you eat, your body converts any calories it doesn't need to
use right away into triglycerides. The triglycerides are stored in your
fat cells. Later, hormones release triglycerides for energy between
meals. If you regularly eat more calories than you burn, you may have
high triglycerides (hypertriglyceridemia).
Triglycerides are a type of fat in the bloodstream
and fat tissue. Too much of this type of fat can contribute to the
hardening and narrowing of your arteries. This puts you at risk of
having a heart attack or stroke. Diseases such as diabetes, obesity,
kidney failure or alcoholism can cause high triglycerides. Often, high
triglycerides occur along with high levels of
cholesterol, another type of fat.
Triglycerides are measured along with cholesterol
as part of a blood test. Normal triglyceride levels are below 150.
Levels above 200 are high. If your triglyceride level is high, you can
lower it by
● Getting medical
treatment for the problem causing the high triglycerides
● Following a healthy diet low in sugars and
carbohydrates
● Exercising regularly
● Taking cholesterol-lowering medicines
More information:
●
Triglycerides (National Heart, Lung, and Blood Institute)
March
23, 2009 Most senior citizens know to watch their cholesterol, but
much less attention is paid to triglycerides, a fat in the blood stream
that can also lead to heart disease. A new study has found high
concentrations of theses blood fats are common among U.S. citizens.