Do women have special concerns about triglycerides?

Q. Dear Dr. Donnica: My doctor told me that having high cholesterol increases my risk of developing heart disease. But my neighbor recently said that I should be concerned about triglycerides, too. What are triglycerides—and are they more of a problem for me because I have diabetes? Also, do women have special concerns about triglycerides?

A. Most of the fat in your body is stored in the form of triglycerides.  Although triglycerides are primarily found in fat tissue, they also circulate in your blood—just like cholesterol—and both are called “lipids.”

Blood tests for triglycerides are part of a complete lipid profile, a routine test to help determine heart disease risk.  Lipid profiles measure total cholesterol, the “good cholesterol” (HDL) and the “bad cholesterol” (LDL) and the triglycerides.

Your risk of heart disease is based on several factors. Having high total cholesterol levels, high LDL levels, low HDL levels, and high triglyceride levels are all  individual risk factors for heart disease.

Diabetes is also a risk factor for heart disease and must be carefully controlled. To lower your risk, your doctor will make recommendations that include lowering your cholesterol and triglyceride levels if they are elevated.

A triglyceride level of less than 150 mg/dL is considered normal; if your level is higher, it is important to lower it.  If you are overweight, following a sensible diet and exercise plan is the first step toward lowering your cholesterol and triglyceride levels. Since you have diabetes, it is especially important that you talk with your doctor about diet and exercise. If you also need medication, your doctor will take all of these issues into consideration when developing the right treatment plan for you.   

High cholesterol and high triglyceride levels often occur together. The type of treatment used to lower your cholesterol may depend on whether your triglyceride levels are high or normal. The risk of developing heart disease doubles when triglyceride levels are above 200 mg/dL. If a person’s triglyceride level is above 200 mg/dL and their “good” HDL cholesterol level is below 40 mg/dL, they are four times more likely to develop heart disease than a person whose triglyceride levels are lower than 200 mg/dL and whose “good” HDL levels are higher than 40 mg/dL.

High triglyceride levels may also increase your risk of developing protein in the urine, a possible sign of kidney failure. If triglyceride levels are very high, there is a risk of developing an underactive thyroid, liver damage, and/or pancreatitis as well.

Be aware that triglyceride levels change in response to meals, so your doctor may ask you to fast in advance of a lipid profile test.  

While elevated triglyceride levels should be a concern for all adults, they are an even greater risk factor for women than they are for men.  First, women should know that heart disease—which is frequently linked to elevated triglyceride levels—kills more than 10 times as many women as breast cancer does each year. In addition, an 88-point increase in triglyceride levels boosts the risk of developing heart disease by 37% for women, compared to only 14% for men.