Triglycerides as a Marker of CV Risk: Too Few Americans Are Aware of Triglycerides’ Important Role in Identifying Cardiovascular Risk
Posted: March 24, 2020 | Word Count: 853
The number of cardiovascular deaths is still on the rise—in fact, cardiovascular disease is the number one cause of death for both men and women in the United States.[i],[ii] Heart attack and stroke each occur on average every 40 seconds, and one cardiovascular death occurs on average every 38 seconds.[iii],[iv],[v]
And while much attention has been devoted to achieving target cholesterol levels to reduce the risk of heart disease, what many people may not know is that independent of cholesterol, triglycerides are also a key factor in cardiovascular risk.
Triglycerides are an important piece of the heart puzzle
Controlling “bad” cholesterol, also known as LDL-C, is often accomplished through statin therapy, which has been shown to reduce the risk of cardiovascular events by 25-35%. But that still leaves 65-75% risk.[vi] This residual risk, or “persistent cardiovascular risk,” may apply to millions of patients, even if they’ve achieved target LDL-C levels.
Persistent cardiovascular risk is especially relevant for patients with high triglycerides, a type of fat in the blood, which can come from foods (like butter, margarine, and certain oils) or can be made in the body from excess calories consumed.
Elevated triglyceride levels are an important identifier of cardiovascular risk: Research shows that people with high triglycerides have 35% more cardiovascular events compared to people with normal triglyceride levels who are taking statins.[vii],[viii],[ix],[x]
Of the roughly 38 million patients in the United States who are on statin therapy, approximately 12 million have elevated triglyceride levels (>150 mg/dL). And more than half of those with elevated triglycerides are estimated to have established cardiovascular disease or diabetes and multiple other cardiovascular risk factors.[xi]
Do you know your numbers?
If you don’t know your numbers, you’re not alone. A recent survey[xii] found that only a little over a third of consumers knew their cholesterol levels; and for triglycerides, the number was just 31%. Those with established cardiovascular disease or diabetics with cardiovascular risk factors were more likely to know their levels. Still, too few are aware of the important measures that affect their cardiovascular risk.
Reducing your heart risk
As always, lifestyle choices remain a key part of reducing heart risk. Eat a healthy diet, rich in fresh fruits and vegetables, high in fiber, and low in saturated fats, trans fat, cholesterol, and sodium. Make sure to get enough physical activity to maintain a healthy weight, and to lower blood pressure, cholesterol, and blood sugar levels. Don’t smoke. And avoid drinking too much alcohol.[xiii]
There are effective, FDA-approved treatments to further reduce your cardiovascular risk, even if you’re on a statin—but it’s important to do your research and stay up-to-date on the current FDA-approved methods. For instance, fibrates, though proven to lower triglycerides and cholesterol, have not been proven to reduce cardiovascular events—in fact, in 2016, the FDA withdrew its previous approval for the use of both fibrates and niacin along with statins, because they determined that the risks outweighed the benefits. Fish oil dietary supplements have not been clinically proven to be safe or effective in the prevention or treatment of cardiovascular risk, and are not FDA-approved to treat, cure, or prevent any disease.
Talk with your doctor about FDA-approved options that can help further reduce your heart risk if you already take statins.
Visit truetoyourheart.com to learn more about cardiovascular disease and how to reduce your risk.
[i] American Heart Association. Heart Disease and Stroke Statistics – 2019 Update: A Report from the American Heart Association. Published January 31, 2019.
[ii] American Heart Association / American Stroke Association. 2017. Cardiovascular disease: A costly burden for America projections through 2035.
[iii] American Heart Association: Heart Disease and Stroke Statistics – 2019 At-a-Glance.
[iv] American Heart Association. Heart Disease and Stroke Statistics – 2019 Update: A Report from the American Heart Association. Published January 31, 2019.
[v] American Heart Association. 2017. Cardiovascular disease: A costly burden for America projections through 2035.
[vi] Ganda OP, Bhatt DL, Mason RP, et al. Unmet need for adjunctive dyslipidemia therapy in hypertriglyceridemia management. J Am Coll Cardiol. 2018;72(3):330-343.
[vii] Budoff M. Triglycerides and triglyceride-rich lipoproteins in the causal pathway of cardiovascular disease. Am J Cardiol. 2016;118:138-145.
[viii] Toth PP, Granowitz C, Hull M, et al. High triglycerides are associated with increased cardiovascular events, medical costs, and resource use: A real-world administrative claims analysis of statin-treated patients with high residual cardiovascular risk. J Am Heart Assoc. 2018;7(15):e008740.
[ix] Nordestgaard BG. Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease - New insights from epidemiology, genetics, and biology. Circ Res. 2016;118:547-563.
[x] Nordestgaard BG, Varbo A. Triglycerides and cardiovascular disease. Lancet. 2014;384:626–635.
[xi] Fan W, Philip S, Toth PP, et al. Prevalence of United States adults with triglycerides ≥ 135 mg/dL: NHANES 2007–2014. Cardiol J. 2019;26(5). DOI: 10.5603/CJ.2019.0000.
[xii] Amarin unbranded campaign, consumer poll, February 2020
[xiii] “Preventing Heart Disease: Healthy Living Habits.” Centers for Disease Control and Prevention, https://www.cdc.gov/heartdisease/medical_conditions.htm