Triglycerides: Why do they matter?

If you've been keeping an eye on your blood pressure and cholesterol levels, there's something else you might need to monitor: your triglycerides.

Having a high level of triglycerides in your blood can increase your risk of heart disease. But the same lifestyle choices that promote overall health can help lower your triglycerides, too.

What are triglycerides?

Triglycerides are a type of fat (lipid) found in your blood.

When you eat, your body converts any calories it doesn't need to use right away into triglycerides. The triglycerides are stored in your fat cells. Later, hormones release triglycerides for energy between meals.

If you regularly eat more calories than you burn, particularly from high-carbohydrate foods, you may have high triglycerides (hypertriglyceridemia).

What's considered normal?

A simple blood test can reveal whether your triglycerides fall into a healthy range:

• Normal — Less than 150 milligrams per deciliter (mg/dL), or less than 1.7 millimoles per liter (mmol/L)
• Borderline high — 150 to 199 mg/dL (1.8 to 2.2 mmol/L)
• High — 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
• Very high — 500 mg/dL or above (5.7 mmol/L or above)

Your doctor will usually check for high triglycerides as part of a cholesterol test, which is sometimes called a lipid panel or lipid profile. You'll have to fast before blood can be drawn for an accurate triglyceride measurement.

What's the difference between triglycerides and cholesterol?

Triglycerides and cholesterol are different types of lipids that circulate in your blood:

• Triglycerides store unused calories and provide your body with energy.
• Cholesterol is used to build cells and certain hormones.

Why do high triglycerides matter?

High triglycerides may contribute to hardening of the arteries or thickening of the artery walls (arteriosclerosis) — which increases the risk of stroke, heart attack and heart disease. Extremely high triglycerides can also cause acute inflammation of the pancreas (pancreatitis).

High triglycerides are often a sign of other conditions that increase the risk of heart disease and stroke, including obesity and metabolic syndrome — a cluster of conditions that includes too much fat around the waist, high blood pressure, high triglycerides, high blood sugar and abnormal cholesterol levels.

High triglycerides can also be a sign of:

• Type 2 diabetes or prediabetes
• Metabolic syndrome — a condition when high blood pressure, obesity and high blood sugar occur together, increasing your risk of heart disease
• Low levels of thyroid hormones (hypothyroidism)
• Certain rare genetic conditions that affect how your body converts fat to energy

Sometimes high triglycerides are a side effect of taking certain medications, such as:

• Diuretics
• Estrogen and progestin
• Retinoids
• Steroids
• Beta blockers
• Some immunosuppressants
• Some HIV medications

What's the best way to lower triglycerides?

Healthy lifestyle choices are key:

• Exercise regularly. Aim for at least 30 minutes of physical activity on most or all days of the week. Regular exercise can lower triglycerides and boost "good" cholesterol. Try to incorporate more physical activity into your daily tasks — for example, climb the stairs at work or take a walk during breaks.
• Avoid sugar and refined carbohydrates. Simple carbohydrates, such as sugar and foods made with white flour or fructose, can increase triglycerides.
• Lose weight. If you have mild to moderate hypertriglyceridemia, focus on cutting calories. Extra calories are converted to triglycerides and stored as fat. Reducing your calories will reduce triglycerides.
• Choose healthier fats. Trade saturated fat found in meats for healthier fat found in plants, such as olive and canola oils. Instead of red meat, try fish high in omega-3 fatty acids — such as mackerel or salmon. Avoid trans fats or foods with hydrogenated oils or fats.
• Limit how much alcohol you drink. Alcohol is high in calories and sugar and has a particularly potent effect on triglycerides. If you have severe hypertriglyceridemia, avoid drinking any alcohol.

What about medication?

If healthy lifestyle changes aren't enough to control high triglycerides, your doctor might recommend:

• Statins. These cholesterol-lowering medications may be recommended if you also have poor cholesterol numbers or a history of blocked arteries or diabetes. Examples of statins include atorvastatin calcium (Lipitor) and rosuvastatin calcium (Crestor).
• Fibrates. Fibrate medications, such as fenofibrate (TriCor, Fenoglide, others) and gemfibrozil (Lopid), can lower your triglyceride levels. Fibrates aren't used if you have severe kidney or liver disease.
• Fish oil. Also known as omega-3 fatty acids, fish oil can help lower your triglycerides. Prescription fish oil preparations, such as Lovaza, contain more-active fatty acids than many nonprescription supplements. Fish oil taken at high levels can interfere with blood clotting, so talk to your doctor before taking any supplements.
• Niacin. Niacin, sometimes called nicotinic acid, can lower your triglycerides and low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol. Talk to your doctor before taking over-the-counter niacin because it can interact with other medications and cause significant side effects.

If your doctor prescribes medication to lower your triglycerides, take the medication as prescribed. And remember the significance of the healthy lifestyle changes you've made. Medications can help — but lifestyle matters, too.