High Blood Triglycerides: Definition of a Risk Marker
Please note that this website is not intended for “most people”. It is written for those who want to stand out in self-health care. If you are such a person, we strongly advise that you give serious thought to all of the suggestions about how to improve your blood lipid profile, triglycerides in particular. If you are tempted to think the suggestions are too complicated or too simplistic, or even biased, we assure you they are not.
A risk marker, or risk indicator, may be defined as an attribute that is associated with an increased probability of occurrence of a disease or other specified outcome and that can be used as an indicator of this increased risk.
A risk marker is not necessarily a causal factor and may also be considered a risk factor. Important emphasis should be placed on this distinction: risk factors may not cause the illness but are associated with factors that bring about increased illness.
I. High Blood Triglycerides: A Risk Marker for Heart Attack
Triglycerides have been well established as a risk factor for coronary artery disease (CAD) for several decades. As early as 1959, higher serum triglyceride levels have been reported in patients with CAD.
Although nearly two-thirds of all coronary heart disease cases in the United States can be at least partly blamed on abnormal triglycerides, triglycerides as a major cause of heart disease have been frequently ignored or neglected(W. Davis, M.D., Lowering Triglycerides and Raising HDL Naturally. Le Magazine, December 2004)
For many years, the importance of triglycerides was a subject of debate. Until the early 1990s, triglycerides were not considered a great threat, so they have been sort of a neglected issue.
For a long time, triglycerides were overshadowed by other blood lipids, in particular, by low-density lipoprotein. In regard to cardiovascular disease, LDL-"bad" cholesterol was considered more important than triglycerides.
In 1994, a research group from University Of Southern California triggered a heated debate in the medical community with the publication of a study linking triglycerides to coronary artery disease, which accounts for 200,000 deaths each year.
Writing in the American Heart Association's journal Circulation, the USC scientists reported that bad cholesterol-LDLs-appeared to be masking arterial damage caused by triglyceride-rich lipoproteins called Very Low Density Lipoproteins (VLDL) and Intermediate Density Lipoproteins (IDL).
The study found that despite aggressive treatment of the bad cholesterol, patients with high triglycerides continued to suffer damage to arterial walls. Using state-of-the-art imaging techniques and specific tests, the scientists found that VLDL and IDL were the culprits.
The danger is similar to not changing the oil in a car. When neglected, both blood and oil get thick, which makes the heart or engine work harder to pump the fluid. The fluid also picks up excess debris and tends to form nasty deposits, which ultimately cause a breakdown. An engine will burn up. In humans, the end result is a heart attack or a stroke.
Recent evidence strengthens the connection between high triglycerides and heart disease. A Harvard-lead study author reported:
The ratio of triglycerides to HDL was the strongest predictor of a heart attack, even more accurate than the LDL/HDL ratio." (Circulation 1997;96:2520-2525).
However, association between triglycerides and HDL-"good" cholesterol is the most difficult to sort out. It turns out that whenever triglycerides are increased, beneficial high-density lipoprotein (HDL) cholesterol decreases.
So is the increased risk seen with high triglycerides due to the triglycerides themselves, or to the associated reduction in HDL cholesterol and increase in LDL cholesterol. So far, nobody can say for sure.
The problem is, people with elevated triglyceride levels almost invariably have other major risk factors for heart disease (mainly obesity, diabetes, and/or high blood pressure), and, so far, it has not been possible to sort out whether the triglycerides themselves pose an independent risk.
Unlike cholesterol, triglyceride particles are large and do not enter the blood vessels and contribute to arterial blockages in the same way cholesterol does.
Still, high triglyceride levels do indicate a defect in the system and recent evidence strongly suggests that they are a significant risk factor for cardiac disease - an early warning of heart trouble.
According to some experts, when triglycerides are at level 60 mg/dL or higher, several abnormal hidden particles begin to appear in the blood:
The Copenhagen Male Study
The New England Journal of Medicine HealthNews (May 11, 1998), highlighted a Danish study involving 3000 healthy men. This study, called the Copenhagen Male Study, found that the risk of having a first heart attack was twice as high in those with the highest triglyceride levels, compared to those with the lowest levels.
Triglyceride levels can range over 1000 (over 5000 in very extreme cases), but the Danish study found that the risk of heart attack substantially rose at levels above 140. (Most nutritionally oriented doctors consider 100 or less "ideal").
The Helsinki Heart Study
The Helsinki Heart Study found that people with a high blood triglycerides level alone - that is that the participants had no other risk factors for heart disease - had about a 50% increased risk for coronary artery disease, compared to people with normal levels.
However, they had a 300% greater risk for coronary artery disease when they had both high blood triglyceride levels combined with high levels of LDL cholesterol.
Add borderline high blood pressure, too (140/90 mmHg or greater), and those people suffered a 500% increase! See the chart below.
Triglycerides in higher amounts are significantly interrelated to metabolism of HDL-"good" and LDL-"bad" cholesterol. They make the blood
Therefore, elevated triglycerides are atherogenic - much more prone to becoming a part of artery-clogging atherosclerotic plaque leading to a heart attack or stroke.
II. High Blood Triglycerides: A Risk Marker for Ischemic Stroke
Researchers have linked high levels of triglycerides to a greater risk of stroke in people with heart disease.
The blood triglyceride levels of more than 11,000 middle-aged and older patients with coronary heart disease were measured. Patients were then monitored for up to 8 years for signs of ischemic stroke, or transient ischemic attack (TIA) - the most common type of stroke, caused by lack of blood flow to the brain.
These results held even after they considered other factors -- like cholesterol levels, age, smoking status, and medical history -- known to affect the risk of stroke.
A Plausible Explanation
Here is a plausible explanation for these findings:
Ischemic stroke, or brain attack results from a type of blood vessel disease similar to heart disease -- both are the end result of arteries damaged and narrowed by plaque. (Strokes which occur when a clot or narrowed artery cuts off the brain's blood supply, account for about 80 per cent of all strokes. The other 20 per cent are due to broken blood vessels in the brain).
Triglyceride-filled particles contribute to the fatty deposits that build up along artery walls, and high triglycerides may make blood cells more likely to clot, setting the stage for a stroke.
The authors note that everyone in this current study had a history of heart disease, which may have amplified the health impact of high triglyceride levels.
It is no surprise to see this. Thus, one who has an elevated triglyceride level, which affects blood vessels in the brain, would have an increased risk of stroke. However, there much more to this.
III. High Blood Triglycerides: A Risk Marker for Fatty Liver and Pancreatitis
Hypertriglyceridemia - blood triglycerides higher than 500 mg/dL, or 5.6 mmol/L - can put you at high risk for such problems as
Acute pancreatitis is associated with severe acute upper abdominal pain and elevated serum levels of pancreatic enzymes.
Most cases are associated with biliary sludge leading to gallstones and alcohol abuse (60-80 percent of cases), but the precise pathogenetic mechanisms are not understood completely.
Other causes of acute pancreatitis include:
The diagnosis is made via clinical exam, laboratory findings, and, if needed, imaging studies such as CT scan, the mainstay for imaging acute pancreatitis and its complications, or MRI, an excellent alternative imaging modality.
The clinical manifestations of hypertriglyceridemia associated with pancreatitis are similar to those seen with other causes with the exception that, for poorly understood reasons, the serum amylase may not be elevated substantially.
Clinical assessment for severe pancreatitis is as accurate as most scoring systems.
Treatment of acute pancreatitis is aimed at correcting predisposing factors and at the pancreatic inflammation itself.
General management consists of supportive care with:
Dietary fats (from food) are absorbed through the gut – the intestines where they are assembled (synthesized) into special “lipid packets” called chylomicrons, a microscopic, minute fat particles formed during fat digestion and assimilation that directly enter the lymphatic system.
Intestinal triglycerides, or chylomicrons, containing approximately 85 percent triglycerides, are then delivered through the bloodstream to the liver, where they are processed (the normal half-life of chylomicrons is about 10 minutes).
(The half-life of a substance refers to the time required to eliminate or metabolize half of the total quantity of the substance from the body following its digestion.)
A history of recurrent episodes of acute pancreatitis is common in people with severe and uncontrolled triglyceride levels, often exceeding 5000 mg/dL, or 56.5 mmol/L.
Chylomicronemia syndrome is an inherited disorder, in which abnormal lipid (fat) metabolism causes chylomicrons (a type of lipids) to accumulate to massive levels in the blood.
This less severe, and often unrecognized, condition usually is caused by triglyceride levels greater than 1000 mg/dL, or 11.3 mmol/L.
However, people with this syndrome, at the onset of symptoms usually have triglyceride elevations greater than 2000 mg/dL, or 22.6 mmol/L and provide a history of recurrent episodes of:
Therefore, in this condition pancreatitis is not necessarily present and pain commonly is mid epigastric, around the stomach. But it may occur in other regions, including the chest or back.
It should be noted that the presentation of hyperchylomicronemia may be confused with conditions such as:
Triglyceride Reduction Formula: All-Natural Blood Lipid Modulator
Nutritional factors are naturally occurring substances, not drugs whose substances are foreign to the body. And, according to orthomolecular nutrition, if the right building blocks (nutrients) are present in the body - in the right amounts and at the right time - the body will do the rest.
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As a complete food supplement, Triglyceride Reduction TGs Formula consists of:
All nutrients are present in specific ratios and amounts in order to correct longer standing deficiencies and imbalances that are known to contribute to elevated levels of blood fats such as triglycerides.
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