Re: Elevated Triglycerides

Posted By CCF Cardio MD-SGM on December 15, 1997 at 10:18:59:

In Reply to: Elevated Triglycerides posted by Anita on December 03, 1997 at 19:56:56:







: Thank you for this wonderful forum!  
I'm wondering if you can tell me the long term effect of elevated triglycerides?  Mine have been in the 338+ range for nearly two years.  For six months, I took Lopid, which did nothing to lower my triglycerides.  My total cholesterol is 223.  I am somewhat concerned that nothing I do seems to bring down the triglyceride level.  Any advice or suggestions you can offer will be greatly appreciated!



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Dear Anita,
The National Cholesterol Education Panel guidelines on treatment of elevated triglycerides take into consideration the degree of coronary artery disease risk, a well as LDL cholesterol levels.  Normal fasting triglyceride(TG) levels are less than 200mg/dl, and 200-400mg/dl is considered borderline high.  Importantly, decisions regarding dietary and drug therapy of a borderline high TG level must be made only in the context of the bigger picture.  For example, if you have optimal LDL(<100), or LDL<130, it's not at all clear that you need aggressive therapy of your triglyceride levels.  However, if your LDL is elevated and you have other risk factors for coronary and peripheral vascular disease(hypertension, diabetes, smoking, premature family history, or known vascular disease), then the threshold for initiating therapy is much lower.  
If your LDL is not optimal, or you have other risk factors for vascular disease, you would be wise to adopt the Step I and then Step II AHA diet, (see link at bottom of this response).  Hand in hand with dietary therapy is weight control, regular exercise, and smoking cessation.  If this therapy is unsuccessful at lowing both LDL and TG's into the optimal ranges, you could consider therapy with medicines such as Gemfibrozil(Lopid), Niacin, or a "statin" drug.
Other important considerations are the following:  Underlying causes of elevated TG's include diabetes, obesity, underactive thyroid gland, and the use of medicines like beta-blockers, water pills, and estrogen replacement therapy.  You should discuss these issues with your doctor and see whether any of them are relevant to your case.  To specifically answer your question, the long-term risk of isolated borderline elevated TG's (without elevated LDL or significant coronary disease risk) is low.
Best of luck.



AHA Step I Diet