A promising new treatment for high triglycerides

When you think about the fat that circulates in the blood, it could immediately think of cholesterol. But there is another type of fat you should not ignore: triglycerides. As with cholesterol, high triglycerides may also increase the risk of having a heart attack. 

Existing drugs for lowering triglycerides are not as good for reducing the risk of heart attack. That is why a report on a new way to reduce triglycerides, published today in the New England Journal of Medicine, generates a certain excitement among cardiologists.

What are triglycerides? 

Triglycerides are a type of fat that circulates in the bloodstream. After eating a snack or a meal, your body breaks down fats in food packages with proteins and cholesterol, and dumped in the bloodstream. After a particularly fatty meal, triglycerides can be so abundant that give blood a milky color. A few hours after a meal, triglycerides cleaned mostly out of the bloodstream.

The American Heart Association has identified four major categories of triglyceride levels:

   *  Health: below 100 milligrams per deciliter of blood (mg / dL)
   *  High Limit: 150 to 199 mg / dl
   *  Top: 200-499 mg / dl
   *  Very High: 500 mg / dL or more.

"High" or "very high" triglyceride levels are associated with an increased risk of heart disease. When the triglyceride level is about 1,000 mg / dL, individuals can develop pancreatitis, a severe inflammation of the pancreas, besides heart disease.

High levels of triglycerides may also be associated with obesity, type 2 diabetes, and a set of risk factors for heart disease known as the metabolic syndrome. Together, these features put a person at particular risk of heart disease.

Drugs to lower triglycerides have been available for some time. The main ones are niacin and a class of drugs called fibrates. But the effects of these drugs are somewhat controversial. For example, two large clinical trials found no benefit of treatment with niacin in the prevention of heart disease events, although niacin two levels of triglycerides and higher levels of heart health ("good cholesterol") cholesterol . Niacin not only does not reduce the risk of heart disease, which also caused stomach, such as skin redness and increased side effects of the infection risk. Therefore, there are reasons to be cautious about taking niacin triglycerides levels.

A large-scale clinical trial of fenofibrate (Tricor, other names), one of fibrates showed that triglyceride levels also reduced, but not to reduce the risk of heart disease. However, the fenofibrate does not seem to help a subset of people in the trial who had particularly high levels of triglycerides and low HDL levels. 

Potential new treatment
 In the report published today in the New England Journal of Medicine, an international team of researchers described a new treatment for high triglycerides. This is a weekly injection of "antisense oligonucleotides" (ASO), the short DNA fragments hepatic triglyceride production. The new report shows that free software can reduce triglyceride levels up to 70%.

Note that this was a Phase 2, which is designed to test if a drug does what it is supposed to do (in this case, a person triglyceride levels). Longer term larger studies are needed to see if OSS effectively reduce the risk of heart disease, and what kind of side effects they cause.

Many experimental drugs that glow in the first tests never become drugs approved by the FDA. We will not know for several years if ASO will be available to people with high triglyceride levels.

Reduction of triglycerides unmedicated
 Unless your triglycerides are extremely high, lifestyle changes are the best place to start. These simple steps can significantly lower the levels of triglycerides.

    *  Beware of bad fats. Cut saturated fat (in red meat and high fat dairy products) and trans fat (in restaurant fried foods and commercially prepared baked goods) can lower triglycerides.

    *  Go for good carbs. Easily digestible carbohydrates (like white bread, white rice, grains, and sugary soda) give triglycerides a boost. Eat whole grains and reducing sodium can help control triglycerides.

    *  Check your drinking. In some people, alcohol dramatically increases triglycerides. The only way to know if this is true for you is to avoid alcohol for a few weeks and have your triglycerides tested again.

    *  Go fishing. Omega-3 fats in salmon, tuna, sardines and other fatty fish can lower triglycerides. Having fish twice a week is fine.

    *  Aim for a healthy weight. If you are overweight, losing just 5% to 10% of your weight can help lower triglycerides.

    *  Get moving. Exercise lowers triglycerides and increases HDL cholesterol heart health.

    *  Stop smoking. It is not good for triglyceride levels - or anything else.