Re: Triglycerides

Posted By CCF Cardio MD-SGM on January 31, 1998 at 17:55:02:

In Reply to: Triglycerides posted by Jim on January 07, 1998 at 19:04:43:







: My triglycerides are high 575. Is there any food that will help lower this
number? I am 30 years old. My doctor wants me to take Lipitor to lower it.
Will a glass of wine a day help lower it? I really don't want to take
Lipitor for the rest of my life. I don't like the idea of taking a synthetic
drugs.



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Dear Jim,
The issue of hypertriglyceridemia, or elevated fasting triglyceride, has received a good deal of attention over the last decade.  Your doctor is concerned about your level of 575 mg/dl (classified as "high") because analysis of numerous prospective studies in asymptomatic, healthy individuals, suggests that elevated triglycerides likely increase ones long-term risk for cardiac events such as heart attack.   Further analysis of these data indicate that increased triglycerides alone, in the absence of elevated LDL or low HDL cholesterol, are less concerning.  Thus, in considering whether to treat elevated triglycerides, it's important to consider the whole lipid profile (including HDL, LDL, and total cholesterol) as well as consider other traditional risk factors for coronary artery disease such as smoking, diabetes, hypertension, and family history of premature heart events.  The point, after all, is to treat those patients at greater risk for cardiac events, while hopefully not subjecting low risk patients to the inconvenience, side-effects, and cost of life-long therapy.
After considering the above discussion, let's move on to treatment of hypertriglyceridemia.  Primary therapy is lifestyle modification, which includes weight control, a diet low in total cholesterol,  total fats, and saturated fats, regular exercise, smoking cessation, and sometimes alcohol restriction.  Regrettably, although moderate red wine intake has been shown to increase HDL cholesterol in certain cases, it is not a treatment for hypertriglyceridemia.  Other considerations include the treatment of diabetes, if this is an issue, as well as the discontinuation of certain medications that may exacerbate problem.
After six months of therapy with the lifestyle modifications I've noted, the measurements should be repeated. At that time, if your lipid profile continues to be significantly abnormal, you might discuss with your physician starting medicines to reduce the risk of future adverse cardiac events.  Again, and I highlight, it's important to consider other risk factors, as well as the HDL and LDL levels before starting medical therapy.  If medical therapy is agreed upon, the first line therapies for this problem are nicotinic acid(known as niacin) and fibric-acid derivatives such as Gemfibrozil.  These medications cause some side effects, mostly gastrointestinal, but are well tolerated by most people.   In the absence of significantly elevated LDL cholesterol, Lipitor is not the medicine for you.   You have not mentioned your LDL in the question, and I can't be more specific at this time.
Best of luck with this problem.  Information provided by the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your physician.