Testing Leads to Concern about Triglycerides

Q:  At my employer’s request, I had a complete physical that included several blood tests, one of which was called a lipid panel.

I thought the only item of importance for that test was my cholesterol. In addition to learning that my cholesterol was slightly elevated, I was told that my triglycerides were very high and that I needed to see my regular physician for further treatment. I did so and was questioned about my family history (very strong for heart disease) and my alcohol use.

I admitted to drinking a six-pack most every night of the week. I was surprised to learn that my doctor said that this might be a major reason for my high triglycerides and that I needed to cut way back. To be honest, that doesn’t seem like that much beer to me. Do you think I need to take the doctor's recommendation seriously? Would drinking less really make a difference?

A:  The short answer is “yes.” One of the areas in which modern medicine has made the greatest strides is in the prevention of heart disease. Through the aggressive treatment of high blood pressure (the guidelines for which have recently changed) and awareness about the importance lowering of blood lipid levels, the numbers of heart attacks, strokes and consequently deaths have been substantially reduced.

As to what is in a lipid panel, it measures four separate blood “fats”: cholesterol, triglycerides, high density lipoprotein (HDL) and low density lipoprotein (LDL).
The following table lists desirable levels for each:

Cholesterol
Desirable level = <200 mg/dL
Borderline high = 200-240 mg/dL
Higher Risk = >240 mg/dL

Triglycerides
Desirable = <200 mg/dL
Borderline = 200-400 mg/dL
Higher Risk: 400-1000 mg/dL

HDL Cholesterol
Desirable = > 35 mg/dL (if no coronary heart disease [CHD])
Higher Risk = <35 mg/dL

LDL Cholesterol
Desirable = <130 mg/dL (If patient has CHD, Desirable = <100 mg/dL)
Borderline = 130-160 mg/dL
Higher Risk = >160 mg/dL

Recent studies have recommended more aggressive guidelines as follows:

• Optimal LDL levels below 100
  
• HDL levels of 40 or higher
  
• Triglyceride levels less than 150

It is definitely worth your while to scale back your consumption of alcohol to no more than 1 or 2 beers per night and to have your triglycerides re-checked before considering a lipid-lowering medication.

Review as well the other values with your family doctor to see if you would benefit from other kinds of treatments or lifestyle modifications. This is especially true for someone with your family history.

"Your Health" provides easy-to-understand information about common health conditions.