Reducing Triglyceride Levels in Patients at Risk for CVD

Almost one-third of adults in the United States have elevated triglyceride levels (>150 mg/dL), and these levels are continuing to rise in adults aged 20 to 49 at rates that mirror those of obesity and diabetes diagnoses among the young. Observational and epidemiologic studies have demonstrated that high triglycerides (200-500 mg/dL) are associated with increased risk of cardiovascular disease (CVD), with the highest levels (≥1,000 mg/dL) associated with an increased risk of pancreatitis. “High triglyceride levels indicate that patients have high levels of circulating cholesterol-rich remnants,” explains Michael Miller, MD. “Cholesterol-rich remnants are highly atherogenic.” Dr. Miller chaired an American Heart Association (AHA) writing committee that published a scientific statement on triglycerides and CVD in the April 18, 2011 issue of Circulation. “There has been little consensus in the literature about the role of triglycerides in coronary disease,” he says. “There has been no detailed statement on triglycerides that has systematically reviewed both the pathophysiologic and clinical trial evidence to date. For this reason, the AHA felt it was necessary to educate healthcare providers about the importance of triglycerides as a biomarker of cardiovascular risk.” He adds that the 2011 AHA position statement analyzed more than 500 international studies from the past 30 years. Helpful Strategies in Reducing Triglycerides Dr. Miller says it is well known that dietary and other lifestyle interventions can help patients lose weight and have a strong effect on triglyceride levels. “These improvements also translate into salutary effects on systolic blood pressure and glucose, reduced insulin resistance, and systemic inflammation, thereby resulting in an improved metabolic profile.” According to the guidelines, substituting unsaturated dietary fats...