Triglycerides (Fat), Cholesterol Both Important to Prevent Brain Stroke and Heart Attack
When we eat fat, it is broken down into glycerol and fatty acids. Our body uses fatty acids as a source of metabolic energy for muscle contractions. One form of fatty acids is triglycerides. So actually triglycerides are the main form of fat in our bodies and in our diets. Those are lipids, used to transport and store fat and are associated with low levels of high density lipoproteins. Later, hormones release triglycerides for energy between meals. If you regularly eat more calories than you burn, you may have high triglycerides (hypertriglyceridemia).
Cholesterol, which is fat, and blood, which is watery, do not mix — just like oil and water. Therefore, for cholesterol to travel in the bloodstream, it is combined with a protein, making a lipoprotein. These are the substances that are measured by a blood test.
They also enable our bodies to metabolize proteins and carbohydrates more efficiently. Despite the many benefits triglycerides have, too much in our blood circulation can cause major health problems, such as heart disease. Elevated triglycerides can be due to overweight/obesity, physical inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates (60 percent of total calories or more). People with high triglycerides often have a high total cholesterol level, including a high LDL (bad) level and a low HDL (good) level. Many people with heart disease and/or diabetes, kidney disease and pancreatitis also have high triglyceride levels.
A simple blood test can reveal whether your triglycerides fall into a healthy range.
- Normal — Less than 150 milligrams per deciliter (mg/dL)
- Borderline high — 150 to 199 mg/dL
- High — 200 to 499 mg/dL
- Very high — 500 mg/dL or above
- Moreover LDL cholesterol (the "bad" cholesterol) should be less than 100 mg/dL and HDL cholesterol (the "good" cholesterol) should be greater than 40 mg/dL.
When triglyceride levels are high (above 150 mg/dL), LDL cholesterol becomes "stickier" and more likely to clog arteries. The major components of total cholesterol are LDL (bad) cholesterol, associated with atherosclerosis (hardening of the arteries) and HDL (good) cholesterol that protects against atherosclerosis. Blood can't flow freely in arteries clogged by deposits of LDL cholesterol, heart attacks and strokes can occur.
Keeping blood lipid levels as low as possible is the key to preventing and even reversing cholesterol plaques within the coronary arteries, which give rise to heart attacks and strokes. While changes in diet are part of the management, it may require a combination of medications to keep the "bad" cholesterol levels (known as LDL) low.
Triglycerides are in the danger zone when they slide above 200 milligrams per deciliter of blood. Higher levels of triglycerides, or blood lipids, have been linked to a heightened risk of heart disease and stroke. High blood glucose levels are linked to the development of diabetes, which itself is a major risk factor for heart disease.
Results of a national survey from the National Lipid Association (NLA) demonstrate that patients-including those at greatest risk-are woefully unaware of the cardiovascular risks associated with unhealthy levels of triglycerides. They revealed that the overwhelming majority of physicians felt patients did not understand triglycerides and were not aware of the differences between triglycerides and cholesterol, or the independent risks unhealthy levels of triglycerides may pose to heart health.
Elevated triglycerides are an even more significant risk factor for women than men. Despite the fact that elevated triglycerides pose a greater threat to women than to men, significantly fewer women reported having discussed the risks associated with high triglycerides with their doctor. "A first step is for doctors to make sure they understand current guidelines, as those surveyed felt they were less familiar with triglyceride guidelines than with those for 'good' or 'bad' cholesterol;" told chairman of the National Lipid Association Consumer Affairs Committee.
Women who had an enlarged waist and elevated levels of upper body fat accumulation (apple shape) known as triglycerides had almost a fivefold increased risk of fatal cardiovascular events compared to women without those traits. Enlarged waist and elevated triglycerides (EWET) are two of five risk factors that the National Cholesterol Education Program (NCEP) uses to characterize the metabolic syndrome (MS). The others are elevated blood pressure, low HDL “good” cholesterol, and impaired fasting blood glucose. Having three of the five factors constitutes a metabolic syndrome diagnosis. This type of obesity is prone to an array of metabolic alterations that increases markedly the relative risk of adverse outcomes; suggested at Journal of the American Heart Association.
Triglyceride levels are usually measured in the fasting state, which could exclude certain types of lipoprotein particles ("remnant" lipoproteins), a possible risk factor for atherosclerosis. According to a study (dated: Jul 2007) by Herlev University Hospital, Herlev, Denmark, and colleagues found that very high levels of nonfasting triglycerides are associated with an increased risk of heart attack, IHD, and death in the general population. The researchers found that with increasing levels (between 150 and 1000 mg/dL) of nonfasting triglycerides, levels of remnant lipoprotein cholesterol increased and the risk for atherosclerosis-related events is significantly also increased as well.
Another study published in the medical journal of the American Academy of Neurology found that those with high triglycerides and elevated "non-high density lipoprotein cholesterol" were more likely to have a large artery atherosclerotic stroke than those with low levels of these fats in the blood.
Those with the highest triglycerides were 2.7 times more likely to have this type of stroke than those with the lowest level. Triglycerides are fatty acids and are the most common type of fat in the blood. Those with the greatest non-high density lipoprotein cholesterol, which is neither the "good" nor the "bad" cholesterol, were 2.4 times more likely to have a large artery stroke.
Researchers from the University of Michigan identify (Dated: Jan. 17, 2008) or confirm genetic variants that increase bad cholesterol are also associated with increased risk of heart disease. Of the seven new variants, two influenced HDL, one influenced LDL, and three influenced triglycerides, which are found in fat and in the bloodstream and like LDL, are associated with increased risk of heart disease. One variant influenced triglycerides and LDL; they stated.
Drugs called statins are used to lower LDL levels in patients, but do not treat obesity. What makes the U of A researchers' findings noteworthy is their discovery of how to inhibit LDL and triglycerides, which are another form of fat in the blood and a leading risk in obesity-related Type 2 diabetes as well as heart disease. It is an important scientific breakthrough in pharmacological interest. Recent evidence also supported their research.
High blood levels of the fats called triglycerides are associated with an increased risk of stroke, a new study (dated: Jan: 2008) finds. "There's a lot of evidence emerging that they have a strong effect on vascular [blood vessel] risk as a whole," said study senior author Dr. Bruce Ovbiagele, associate professor of neurology at the University of California, Los Angeles.
The study of more than 1,000 people treated for ischemic stroke -- the kind that happens when a clot blocks a blood vessel of the brain -- found that those with the highest levels of triglycerides were more than twice as likely to suffer such a stroke. The findings are published in the issue of Neurology.
Like cardiologists, neurologists concerned with the bad effects of blood fats have concentrated mostly on LDL cholesterol, the "bad" kind that forms artery-blocking clots, Ovbiagele said. The benefits of lowering LDL cholesterol levels, in terms of heart disease and stroke, are well known, he said.
"Our study would seem to indicate that triglycerides are more important than LDL cholesterol," he said. "But they haven't been studied in the way of reducing their levels and seeing if that reduces stroke risk. If we reduced triglycerides as aggressively as we reduce LDL cholesterol, we might have equally lower risk, but nobody knows."
The role of LDL cholesterol and other blood fats in stroke has drawn increasing attention from a new breed of specialist, the vascular neurologist, said Dr. Cathy Sila, head of vascular neurology at the Cleveland Clinic. The study of blood vessels in stroke is much more complex than in heart disease because of the great variety of vessels to be dealt with and the different kinds of stroke that can occur, Sila said.
"Almost all heart attacks are due to atherosclerosis," she said, referring to artery blockage. "Only about half of ischemic strokes are related to atherosclerosis. And we have vessels as big as the carotid artery, which is the size of a pencil; intracranial arteries, the size of linguini; and vessels in the brain as big as the size of a human hair."
The connecting factor in assessing the risk of ischemic stroke in many cases is not just blood levels of fat but the metabolic syndrome, a constellation that includes high blood fat levels, high blood pressure levels and obesity, Sila said.
Success in lowering cholesterol levels with statin drugs has meant "a lack of attention paid to other lipid fractions," she said. The reported association between triglyceride levels and stroke reinforces the standing recommendations for reducing known risk factors for vascular disease, both Sila and Ovbiagele said.
"We should focus on reducing LDL cholesterol as a primary goal but not ignore triglycerides," Ovbiagele said. "We should also consider a trial to lower triglycerides to see if we can improve on the benefits we get from lowering LDL cholesterol."
The ideal cholesterol level is determined based on an individual's risk of stroke or heart disease. Everyone should test own cholesterol, triglycerides and blood sugar levels every 5 years until the age of 40 and every year after that. But losing weight is definitely a lifestyle change. There's no quick fix.
Moderate drinking is good for the heart, unless you are a "responder" in whom alcohol dramatically boosts triglycerides. Omega-3 fats in some fish lower triglycerides. Good diabetes control helps to lower both triglycerides and LDL. If your cholesterol and triglyceride levels are off-target, you can take these steps:
- Work with a dietitian to develop your own meal plan.
- Use less oil, butter, margarine, and other fats when cooking.
- Choose low-fat dairy products.
- Eat small servings of meat, fish, and poultry.
- Eat more fruits and vegetables.
- Choose whole-grain bread and cereal.
- Try to exercise for 30 minutes most days.
- Follow your health care provider’s instructions for taking medicine.
- If you smoke, get help to quit.
- Several medicines can help you reach your target cholesterol goals. Talk with your health care provider about the best medicine for you.
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