Newsletters - July 2000

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In a recent 20-year study, researchers found that elevated triglycerides, a common type of blood fat in the human body, sharply increase one’s risk of dying from a heart attack, even if the person’s blood cholesterol levels are normal.

This is a landmark study because it is the first of its kind to profile families. Dr. Melissa Austin and coworkers used medical history data collected in the early 1970s from 101 families who had cardiovascular disease and high triglyceride levels. They then traced the health status and cause of death of 685 family members for the next 20 years. The study compared the risk of heart disease death between siblings and offspring versus spouses of individuals with one or two of the common lipid disorders- familial combined hyperlipidemia (FCHL), high triglyceride levels in combination with elevated cholesterol levels in families, and familial hypertrigleridemia (FHTG), elevated triglyceride levels in families. A unique aspect of the study was that most of the family members were relatives of individuals who had a heart attack as well as elevated triglycerides.

The findings of the study are as follows:

  1. Siblings and the offspring of families with FCHL had a 70% higher risk of dying from cardiovascular disease compared to spouses.
  2. A 2-3 fold increased risk of cardiovascular death was predicted in families with FHTG, and it was independent of cholesterol levels.

The life-threatening effects of high triglyceride levels is due to the fact that excess triglycerides can increase the concentrations of 2 types of fat particles, chylomicrons, lipoproteins of the lowest density, and very low density lipoproteins (VLDL). Both contribute to the fatty deposits that obstruct blood flow, increasing one’s risk for a heart attack.

This study has made it evident that knowledge of one’s family history of cardiovascular disease is important because from this information heart attack deaths may be predicted years in advance. To prevent such deaths, levels of both cholesterol and triglycerides should be measured when patients undergo lipid profile testing.

The total number of American families affected by FCHL and FHTG is not known, but Dr. Austin suspects that they probably account for a large number of heart attack deaths nationwide. According to Austin, the next step in preventing and developing treatments for people with cardiovascular disease is to investigate the underlying mechanisms that cause high triglyceride levels to run in families.

Source:
American Heart Association (The 20 year study by M.A. Austin et al. appears in Circulation 2000 Jun 20;101(24), 2777-82.)

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