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What is Coronary heart disease (CHD)?

Coronary heart disease (CHD) is the most common form of heart disease and affects approximately 12.6 million Americans. Most often, it results in a heart attack. According the statistics provided by the National Heart, Lung and Blood Institute, close to 1.1 million Americans suffer a heart attack each year, with 515,000 of them being fatal. As a result, prevention is critical to saving lives.

CHD occurs as the result of several processes. It begins when blood flow to the heart is reduced because of atherosclerosis.

With atherosclerosis, plaque (e.g. cholesterol) begins to build up in the walls of blood vessels and arteries. This plaque causes blood and other components to stick to the walls of the blood vessels. This process, repeating over time, causes the blood vessels to harden while at the same time making them smaller.

With CHD, atherosclerosis affects the arteries that lead to the heart. The build up associated with atherosclerosis can then break open, which causes a blood clot. The clot covers the area that has broken open, thus further reducing blood flow to the heart as the clot hardens. Again, this process repeats over the course of time resulting in less and less blood flow to the heart.

What role do triglycerides play in the development of CHD?

There has been some debate as to whether elevated triglycerides alone are a risk factor for coronary heart disease; however, recent studies and data shows that it is indeed a risk factor and can be a predictor for other events.

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The Framingham Heart Study showed a simple relationship between triglyceride level and risk for CHD. (show data). Interestingly, for women the study showed an even more significant correlation when other risk factors were taken into account (except HDL cholesterol).

Another study, referred to as the Copenhagen Male Study, studied 2906 white men between the ages of 53 and 74 over an 8 year period. When the study began, these individuals were diagnosed as not having cardiovascular disease. In the follow-up time, 229 men had experienced their first ischemic event.

Furthermore, when divided into three groups based upon triglyceride level, the group with the lowest level was 4.6% likely to have had an event, the second group was 7.7% and the third 11.5%. What this means is than those who were in the second highest triglyceride group were 50% more likely to have had an ischemic event than those in the lowest group. Those men in the highest triglyceride range were 120% more likely to have had an event than those in the lowest group.

The study also showed that for men in the highest triglyceride group, who also happened to have elevated HDL (the “good” cholesterol), the protection afforded by elevated HDL did not significantly reduce their risk for an ischemic event.

The Copenhagen Male Study shows a strong link between high triglyceride level and risk for coronary heart disease, independent of other risk factors (such as age, smoking, weight, etc.).



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