Lipoprotein Checklist: Triglycerides
Triglycerides are an important risk factor for
coronary plaque growth, even at levels previously thought to be
normal. Elevated triglycerides commonly occur along with low HDL,
but they also act independently. High triglycerides are a common
cause of heart disease, even in people with low or normal
cholesterol values. It is crucial that you (and your doctor) pay
close attention to triglycerides if you are to succeed in
controlling your plaque.
The liver produces a particle called “very low-density lipoprotein”,
or VLDL, packed full of triglycerides. The higher your
triglycerides, the more VLDL you will have. Sometimes triglycerides
are increased due to genetic factors. Genetic causes cause
triglycerides to range as high as several thousand mg/dl. More
commonly, triglycerides are high (>100 mg/dl to 400 mg/dl) due to
excess weight, indulging in processed carbohydrates, and resistance
to insulin (metabolic syndrome).
When VLDL particles in the blood come into contact with LDL and HDL
particles, the triglycerides of VLDL are passed onto LDL and HDL,
which become bloated with triglycerides as a result.
Triglyceride-loaded LDL and HDL are a ready target for enzymes in
the blood and liver that reconfigure these particles into smaller
versions, small LDL and small HDL. Recall that both small LDL and
HDL are undesirable particles that stimulate plaque growth. Thus,
excess triglycerides and VLDL are behind the creation of small LDL
and small HDL.
This process begins at 45 mg/dl or greater and gets really bad with
triglycerides >100 mg/dl. In the Track Your Plaque program, we aim
for zero plaque growth or reduction, and so we target triglyceride
levels of 60 mg/dl or less.
You’ll notice that low HDL and increased triglycerides are also
patterns that characterize the metabolic syndrome. In our
experience, over 50% of adults show at least some of the
characteristics of the metabolic syndrome. In our society of
inactive, sedentary lifestyles and packaged, processed foods,
metabolic syndrome is rampant. That means increased triglycerides
from VLDL are also running rampant. The result: a 3 to 7-fold
increase in risk for heart attack. Eliminating the metabolic
syndrome is another battle we need to fight to conquer plaque. (See
the Track Your Plaque Special Report
Shutting Off the Metabolic Syndrome)
How to Reduce Triglycerides
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