Incident CHD Risk Elevated With High Triglycerides, Low HDL

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Risk of both ischemic stroke and coronary heart disease was elevated with high triglycerides and low HDL cholesterol.
Risk of both ischemic stroke and coronary heart disease was elevated with high triglycerides and low HDL cholesterol.

HealthDay News—A high fasting triglyceride TG level combined with a low high-density lipoprotein cholesterol (HDL-C) level is associated with increased risks of incident coronary heart disease (CHD) and ischemic stroke, especially for patients with diabetes or a low-density lipoprotein cholesterol (LDL-C) level of ≥130 mg/dL, independent of other atherosclerotic cardiovascular disease risk factors, according to a study published online in Diabetes Care.

Jennifer S. Lee, MD, from the Stanford University Medical Center in California, and colleagues studied 3,216 American Indians (41% with diabetes) who were free from cardiovascular disease at baseline in a prospective cohort (median follow-up: 17.7 years). The authors estimated hazard ratios (HRs) for incident ischemic stroke and coronary heart disease in relation to combined triglyceride and HDL-C status (fasting triglyceride level ≥150 mg/dL was high; fasting HDL-C level <40 mg/dL [for men] was low).

The researchers found that, compared to those with normal triglyceride and HDL levels, participants with high triglyceride  and low HDL levels had a 1.32-fold elevated HR for CHD. In participants with, but not those without, diabetes, high triglyceride plus low HDL levels correlated with a 1.54- and 2.13-fold increased HR for CHD and stroke, respectively (P value for interaction =.003 and .060, respectively). In participants with LDL-C levels of ≥130 mg/dL, high triglyceride and low HDL correlated with CHD risk; this was not seen in participants with lower LDL-C levels. The correlations were not modified by sex.

"Adults with both high triglycerides and low HDL-C, particularly those with diabetes, have increased risks of incident CHD and stroke," the authors write. "Recognition of these patterns may help to enhance lipid-targeted strategies to prevent CHD and ischemic stroke."


Lee JS, Chang P-Y, Zhang Y, Kizer JR, Best LG, Howard BV. Triglyceride and HDL-C dyslipidemia and risks of coronary heart disease and ischemic strokoe by glycemic dysregulation status: the strong heart study [published online January 30, 2017]. Diabetes Care. doi: 10.2337/dc/dc16-1958

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