Triglycerides a Stroke Hazard, Even With Statin Remedy
THURSDAY, March 17, 2022
Stroke survivors could also be watching their “dangerous” ldl cholesterol, however a brand new research suggests one other kind of blood fats may put them liable to a repeat stroke throughout the subsequent yr.
Researchers discovered that stroke survivors with excessive triglycerides suffered repeat strokes at about twice the speed of survivors with regular triglyceride ranges. Their threat of coronary heart assault and extreme chest ache have been equally raised — even when they have been taking cholesterol-lowering statin medicine.
Nevertheless, specialists mentioned it isn’t clear that top triglycerides, per se, have been in charge.
They might merely be a marker of one thing else that is occurring, mentioned Dr. Leah Dickstein, a scientific assistant professor of neurology at NYU Langone Well being in New York Metropolis.
“We do not know that treating excessive triglycerides will decrease these dangers,” mentioned Dickstein, who was not concerned within the research.
The excellent news, she added, is that lots of the issues routinely really helpful to stroke survivors will assist handle their triglycerides. These embrace a food plan low in saturated fats and processed carbohydrates, common bodily exercise, and avoiding alcohol.
LDL (“dangerous”) ldl cholesterol will get many of the consideration, however triglycerides are one other blood fats that may soar when persons are chubby, eat too many energy (particularly from meals excessive in sugar or saturated fats) and drink excessively. Excessive triglycerides additionally are likely to go hand-in-hand with circumstances like weight problems, kind 2 diabetes, kidney illness and hypertension.
Nevertheless, it has been unclear whether or not excessive triglycerides predict a poorer prognosis for stroke survivors.
For the brand new research, Dr. Takao Hoshino and colleagues at Tokyo Ladies’s Medical College adopted 870 sufferers at their hospital. All had not too long ago suffered a stroke or “mini-stroke.” On the outset, one-quarter had excessive triglycerides, outlined as 150 mg/dL or increased.
Over the following yr, these sufferers suffered main “cardiovascular occasions” at increased charges than stroke survivors with regular triglyceride ranges.
Roughly 16% had a second stroke, in contrast with 8% of sufferers with regular triglycerides. In the meantime, 4% had a coronary heart assault or chest ache brought on by restricted blood move to the center, versus lower than 1% of the normal-triglyceride group, the findings confirmed.
The researchers have been in a position to account for another elements, like weight problems, diabetes and kidney illness. And excessive triglycerides, themselves, have been nonetheless linked to an elevated threat of repeat stroke or coronary heart issues. That was true whether or not sufferers have been taking cholesterol-lowering statins or not.
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One other U.S. neurologist agreed, although, that top triglycerides will not be the direct trigger.
It is potential the elevated dangers have been a minimum of partly because of different, unmeasured elements, mentioned Dr. Larry Goldstein, a volunteer knowledgeable with the American Coronary heart Affiliation/American Stroke Affiliation.
Plus, the research was completed at a single medical heart in Japan — and the findings might not generalize to sufferers elsewhere, mentioned Goldstein, who can also be co-director of the Kentucky Neuroscience Institute, in Lexington.
In Japan, he defined, it’s normal for strokes to be associated to hardened, narrowed arteries throughout the mind. In Western nations, Goldstein mentioned, it is extra widespread for stroke sufferers to have illness within the neck arteries that offer blood to the mind.
That mentioned, excessive triglycerides deserve consideration, each neurologists mentioned.
Triglycerides are measured as a part of the usual “lipid panel” that gauges levels of cholesterol, Goldstein famous. If they’re excessive, he mentioned, a repeat measurement ought to be taken — after an in a single day quick, since meals have an effect on triglyceride ranges.
“I do not assume sufferers ought to panic over a single quantity,” Dickstein confused.
As an alternative, she mentioned, individuals with excessive triglycerides can give attention to the life-style adjustments that won’t solely assist with that difficulty, however profit their general well being.
In some circumstances, Dickstein famous, individuals might have treatment particularly for top triglycerides. These choices embrace niacin, fibrate medicines (equivalent to fenofibrate and gemfibrozil), and prescription-grade fish oil.
However, Dickstein mentioned, extra analysis is required to show that concentrating on triglycerides really reduces stroke threat.
Goldstein inspired individuals with excessive triglycerides to speak to their physician in regards to the numerous methods they will cut back their threat of cardiovascular hassle.
The findings have been revealed on-line March 16 within the journal Neurology.
Extra data
The U.S. Nationwide Library of Drugs has extra on excessive triglycerides.
SOURCES: Leah Dickstein, MD, scientific assistant professor, division of neurology, NYU Langone Well being, New York Metropolis; Larry Goldstein, MD, professor and chairman, division of neurology, affiliate dean for scientific analysis, co-director, Kentucky Neuroscience Institute, Lexington, Ky., and volunteer knowledgeable, American Coronary heart Affiliation/American Stroke Affiliation, Dallas; Neurology, March 16, 2022, on-line
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