Triglycerides may be the key to preventing heart disease

In exciting news for health care professionals, new evidence has been found in two separate studies that might help prevent heart disease. The research examined triglyceride levels, and found that gene mutations that stop the Apolipoprotein C-III (APOC​₃) function can lower the risk of coronary heart disease by as much as 40 percent.¹ In the field of pharm tech, this might be the key to creating drugs that significantly lower the risk of heart attack and stroke. However, it is still too early to tell the exact impact of triglycerides in relation to heart health. These studies continue to garner media attention, specifically within the pharmaceuticals industry, however the results have no immediate impact on clinical treatment.That being said, some companies have already started the process of developing and testing new drugs to reduce APOC₃ levels, though it may be months or years before these drugs hit the market.

What are triglycerides?

Triglycerides are a type of lipid found in the blood.² The average triglyceride level of adults in the United States is 147 milligrams per deciliter.³ Those with certain gene mutations have significantly lower triglyceride levels and a lower risk of heart disease, though the exact correlation between these two trends is not yet fully understood.⁴ Traditionally, triglyceride levels have been measured along with cholesterol. Cholesterol is similar to triglyceride in that it is a lipid that moves through the bloodstream.

What studies are revealing about triglycerides

Two studies recently published in the New England Journal of Medicine came to similar conclusions about the major possibility that triglycerides could be a main cause of heart attacks. The studies focused on variants that stopped the production of APOC_3​, which effectively lowered triglyceride levels. The two studies combined used data from almost 200,000 participants.

Heart disease in general is responsible for approximately a quarter of the deaths in the United States each year.⁵ When present in their proper levels, triglycerides along with high-density lipoprotein (HDL) and low-density lipoprotein (LDL) help keep the heart healthy. However, when this balance is distorted by external factors such as poor diet, excessive smoking, obesity or lack of exercise, there’s an increased risk of plaque build up.⁶ While HDL and LDL have historically been the major focus of research on heart disease, these new studies have put triglycerides at the forefront of modern science.

A small drug company in California found other promising evidence using a drug on patients that suffered from disorders that elevated triglyceride levels to the point of potentially being fatal. The company, Isis, was able to slash triglyceride levels by up to 71 percent.⁷

Methods for lowering triglyceride levels include exercising, losing excess weight, lowering calorie intake, drinking less alcohol and eliminating sugars and trans fats from your diet.

What is HDL?

High-density lipoprotein, often referred to as “good cholesterol,” has been a major focus in regard to heart health. Cholesterol is a waxy substance that travels throughout the body performing various functions, and at times can build up to excess, which prevents functionality.⁸ HDL works to find excess cholesterol in the bloodstream and return it to the liver to be broken down. This is why high levels of HDL are considered beneficial, as more of the cholesterol can aid in clearing up build ups.

For years, this has lead to the belief by health care professionals that raising levels of HDL will help protect the heart. Now with recent research about triglycerides, scientists are less sure. However, HDL is still considered a reliable predictor of heart health, whereas once high levels of HDL were considered the key to preventing heart disease, emphasis is now shifting towards triglycerides.⁹ In other words, high HDL levels continue to be a sign of good heart health, but might not necessarily alter a patient’s risk of heart disease.

What is LDL?

Often referred to as “bad cholesterol,” LDL has been linked to heart disease for sometime. LDL works in the opposite manor of HDL by delivering cholesterol around the body. When too much cholesterol is distributed throughout the body, it continues to circulate and builds up.

Managing LDL levels has proven an effective way of fighting heart disease, and many drugs, specifically statins, work to lower LDL levels. This is also why balancing LDL and HDL is important, as the former works as a cholesterol distributor and the latter works as a clean-up crew.¹⁰

For pharmaceutical companies, finding effective drugs to mimic the mutations that lower triglyceride levels could alter preventative measures taken in eliminating heart disease. One of the major benefits of this research is a deeper examination of what genuinely causes heart disease, veering away from simply avoiding LDL and maximizing HDL. Finding effective ways to harmoniously lower LDL and triglyceride levels while keeping a healthy amount of HDL will be a continuing challenge for health care professionals.

^{1 “}Large Genetic Studies May Help Unravel The Triglyceride Problem” by Larry Husten. Forbes. June 19, 2014. http://www.forbes.com/sites/larryhusten/2014/06/19/large-genetic-studies-may-help-unravel-the-triglyceride-problem/ 

^{2 “}Triglycerides: Why do they matter?” by Mayo Clinic Staff. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186?pg=1

³“In Single Gene, a Path to Fight Heart Attacks” by Gina Kolata. New York Times. June 18, 2014. http://www.nytimes.com/2014/06/19/health/scientists-identify-mutations-that-protect-against-heart-attacks.html

⁴“In Single Gene, a Path to Fight Heart Attacks” by Gina Kolata. New York Times. June 18, 2014. http://www.nytimes.com/2014/06/19/health/scientists-identify-mutations-that-protect-against-heart-attacks.html

⁵“You probably know less about cholesterol than you think you do. Here’s some help.” by Gisela Telis. Washington Post. June 16, 2014. http://www.washingtonpost.com/national/health-science/you-probably-know-less-about-cholesterol-than-you-think-you-do-heres-some-help/2014/06/16/d9fa9350-e4fa-11e3-8f90-73e071f3d637_story.html

⁶“You probably know less about cholesterol than you think you do. Here’s some help.” by Gisela Telis. Washington Post. June 16, 2014. http://www.washingtonpost.com/national/health-science/you-probably-know-less-about-cholesterol-than-you-think-you-do-heres-some-help/2014/06/16/d9fa9350-e4fa-11e3-8f90-73e071f3d637_story.html

⁷“In Single Gene, a Path to Fight Heart Attacks” by Gina Kolata. New York Times. June 18, 2014. http://www.nytimes.com/2014/06/19/health/scientists-identify-mutations-that-protect-against-heart-attacks.html

⁸“HDL cholesterol: How to boost your ‘good’ cholesterol” by Mayo Staff. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/hdl-cholesterol/art-20046388

⁹“Boston scientists say triglycerides play key role in heart health” by Carolyn Y. Johnson. Boston Globe. June 18, 2014. http://www.bostonglobe.com/news/science/2014/06/18/boston-researchers-find-that-triglycerides-play-pivotal-role-heart-health/ynrM4QQwIq1fCCoRwMfOAN/story.html

¹⁰“HDL cholesterol: How to boost your ‘good’ cholesterol” by Mayo Staff. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/hdl-cholesterol/art-20046388