In today’s health environment, thanks to aggressive marketing by the pharmaceutical companies promoting the near godlike power of the statins to lower levels, most everyone knows where their cholesterol sits. The reality is that total cholesterol, as a risk factor for heart attacks and cardiovascular mortality, is just short of worthless. The more important value, however, is not known by most people.
Triglycerides have long been known to be a major player in heart disease risk. The relationship between triglycerides and HDL (“good”) cholesterol is a key factor to look at in evaluating your risk. Ideally, a ratio of 2:1 or less is desirable. There are only a handful of patients I have seen where the triglycerides are close to or even lower than the HDL levels.
There reason these levels are so important is that they are driven by our relationship between our insulin and our cells (i.e. prediabetes). Since prediabetes and diabetes absolutely destroy our cardiovascular system you can see why this ratio is so important.
This particular study further reinforces this, finding that non-fasting levels of triglycerides were the strongest predictor of total mortality. While non-fasting cholesterol levels were associated with risk of heart attack, the risks of high non-fasting triglycerides were much more severe. Levels above 443 (normal fasting values should be well under 150) increased the risk of heart attack by 420% and risk of death overall by 50%. THIS is why you need to know your numbers.