Sunday, April 1, 2012

Elevated Triglyceride levels increase the risk of STROKE in postmenopausal women

Dyslipidemia , especially elevated Total cholesterol ,LDL cholesterol  and decreased HDL, are well  established risk factors for the development of atherosclerotic heart disease .

They have not served as well as a marker of increased risk for ischemic stroke.

 However  medications such as Statins , which primarily lower LDL and total cholesterol , have demonstrated a significant reduction in stroke risk. This was well demonstrated in the CARDS study( lancet364(Aug.21,2004):685-696 ) which found a 48% reduction in stroke in patients with Type 2 diabetes taking 10 mg of atorvastatin ( lipitor).

I read an article this morning in the April issue of * STROKE that may help in our understanding of some of the risk factors for ischemic stroke in women. This article has a complicated title, Lipid and Lipoprotein Biomarkers and the Risk of Ischemic Stroke in Postmenopausal Women , and was  also not a quick easy read. This study was a prospective case study comparing 972 women with ischemic stroke to 972 matched control subjects.

Bottom line
  Elevated baseline triglyceride levels above the mean Triglyceride level of 140 mg/dl was a significant marker of increase risk of ischemic stroke in post menopausal women.

 Two other associated risk markers involve precursors to LDL cholesterol ;
  VLDL particle Size and IDL number,

Our liver produces VLDL ( very low density lipoprotein ) which is altered to IDL ( intermediate density lipoprotein ) and to the end product LDL( low density lipoprotein ) . Elevated triglyceride levels have an unfavorable effect on this process resulting in smaller more dense higher risk LDL particles.

 LIVER  produces ----------------> VLDL ------> IDL------> LDL
 Elevated Triglycerides effect- ->  size of             number of         smaller dense  higher risk LDL particles

     This article helps point the finger at elevated Triglyceride levels as being a risk factor for 
       stroke in postmenopausal women 

       It  also helps explain how elevated triglycerides effect the size and  and possible the 
       number of  LDL particles to increase someones increased risk for stroke and heart disease . 

       It also improves our understanding of the benefits of Statins , like lipitor and others , in 
       reducing stroke risk.

 Have fun, be smart and pay attention to your Triglyceride test results
 David Calder,MD
* STROKE vol. 43 number 4 april 2012    pages 958-966

1 comment:

  1. This blog is great source of information which is very useful for me. Thank you very much.

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Your comments and questions are appreciated. David Calder,MD