Harvard Women's Health Watch

Experts urge intensive lifestyle measures for lowering triglycerides

When cholesterol is measured, so are triglycerides, another type of blood fat that's an independent risk factor for heart disease. High triglycerides increase the likelihood of developing heart disease even when cholesterol levels are normal, especially in postmenopausal women. But triglycerides haven't gotten as much attention as LDL (bad) cholesterol and HDL (good) cholesterol, partly because their role in heart disease and stroke hasn't been well understood.

In recent years, scientists have learned more about how triglycerides are metabolized and how they contribute to atherosclerosis, the clogged arteries that raise the risk of heart attack, stroke, and other cardiovascular problems. High triglyceride levels are often correlated with low HDL and a type of LDL cholesterol that is particularly likely to produce harmful deposits in the arteries. High triglyceride levels are also a component of another heart disease risk factor — metabolic syndrome, a condition that occurs in most people with type 2 diabetes and includes high blood pressure and a large waist size. The American Heart Association (AHA) issued a scientific statement about triglycerides and cardiovascular disease that sets a new, lower optimal level of triglycerides and recommends intensive lifestyle measures for reducing elevated triglycerides. The AHA statement and a review of research were published online April 18, 2011, in the journal Circulation. Here are some of the highlights:

Research in women. In the United States, 27% of women have elevated triglyceride levels — that is, 150 milligrams per deciliter (mg/dL) of blood or more (see "Triglyceride levels"). On average, Mexican American women have the highest triglyceride levels and black women the lowest levels, with non-Hispanic white women in between. As women go through menopause, triglyceride levels increase; the relative influence of aging, hormonal changes, and lifestyle changes (lower levels of physical activity, for example) isn't clear. In the Study of Women's Health Across the Nation, triglyceride levels were at their highest during late perimenopause and early postmenopause. Estrogen taken orally — but not transdermally (by patch) — raises triglyceride levels; progestins can counter this effect. Tamoxifen (taken for prevention and treatment of breast cancer) can cause a marked increase in triglycerides.

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