Hormonal
Elevated levels of triglyceride-rich lipoproteins (TRL) and their remnants are causally associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD), including myocardial infarction, ischemic stroke, and aortic valve stenosis, independent of LDL cholesterol levels.
High triglycerides are not just a number; they represent particles that directly contribute to heart disease. If your triglycerides are consistently above 1.2 mmol/L (100 mg/dL), you have elevated cardiovascular risk, even if your LDL is normal. Managing this involves dietary changes to reduce carbohydrate and alcohol intake, and potentially medication if lifestyle changes are insufficient, especially if you have diabetes or existing heart disease.
Recent advances in human genetics, together with a large body of epidemiologic, preclinical, and clinical trial results, provide strong support for a causal association between triglycerides (TG), TG-rich lipoproteins (TRL), and TRL remnants, and increased risk of myocardial infarction, ischaemic stroke, and aortic valve stenosis.
Why this rating
The consensus statement cites Mendelian randomization studies, large epidemiologic data, and clinical trial results as strong evidence.
Source
Triglyceride-rich lipoproteins and their remnants: metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies—a consensus statement from the European Atherosclerosis Society
Henry N. Ginsberg et al. · European Heart Journal · 2021
DOI 10.1093/eurheartj/ehab551
More from this paper
- Apolipoprotein CIII (apoCIII) acts as a key inhibitor of lipoprotein lipase (LpL), and its reduction leads to more efficient clearance of triglycerides from the blood, thereby lowering plasma triglyceride levels and potentially reducing cardiovascular risk.Strong
- Non-fasting (postprandial) triglyceride levels are a significant and often neglected risk factor for premature ASCVD, as the postprandial state is the norm for most of the day and involves the accumulation of atherogenic remnant particles.Good
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