Coronary Heart Disease Risk Associated with Primary Isolated Hypertriglyceridemia; a Population‐Based Study

Abstract

Background Hypertriglyceridemia is associated with increased risk of coronary heart disease but the association is often attributed to concomitant metabolic abnormalities. We investigated the epidemiology of primary isolated hypertriglyceridemia (PIH) and associated cardiovascular risk in a population‐based setting. Methods and Results We identified adults with at least one triglyceride level ≥500 mg/dL between 1998 and 2015 in Olmsted County, Minnesota. We also identified age‐ and sex‐matched controls with triglyceride levels <150 mg/dL. There were 3329 individuals with elevated triglyceride levels; after excluding those with concomitant hypercholesterolemia, a secondary cause of high triglycerides, age <18 years or an incomplete record, 517 patients (49.4±14.0 years, 72.0% men) had PIH (triglyceride 627.6±183.6 mg/dL). The age‐ and sex‐adjusted prevalence of PIH in adults was 0.80% (0.72–0.87); the diagnosis was recorded in 60%, 46% were on a lipid‐lowering medication for primary prevention and a triglyceride level <150 mg/dL was achieved in 24.1%. The association of PIH with coronary heart disease was attenuated but remained significant after adjustment for demographic, socioeconomic, and conventional cardiovascular risk factors (hazard ratio [HR], 1.53; 95% CI, 1.06‐2.20; P = 0.022). There was no statistically significant association between PIH and cerebrovascular disease (HR, 1.06; 95% CI, 0.65‐1.73, P = 0.813), peripheral artery disease (HR, 1.27; 95% CI, 0.43‐3.75; P = 0.668), or the composite end point of all 3 (HR, 1.28; 95% CI, 0.92‐1.80; P =0.148) in adjusted models. Conclusions PIH was associated with incident coronary heart disease events (although there was attenuation after adjustment for conventional risk factors), supporting a causal role for triglycerides in coronary heart disease. The condition is relatively prevalent but awareness and control are low.

The burden of severe hypercholesterolemia and familial hypercholesterolemia in a population-based setting in the US

“…We ascertained FH based on clinical criteria as genetic testing data were not available for the study population. In prior studies, clinical and genetic FH have only modest overlap [ 16 , 39 ]. Our estimates are based on available lipid test results, and we cannot ascertain SH in the absence of lipid testing.…”

“…The ‘point prevalence’ was estimated using a simple cross-sectional method whereby the person-years denominator was limited to the Olmsted population on July 1st of 2015, and the cases were limited to those with index date on or before that date who were still alive and resident in Olmsted County on July 1st of 2015. The ‘period prevalence’ was estimated using an age-recursive method, that incorporated estimates of age-specific incidence and relative survival as previously described [16] (details provided in the Supplementary Material). It represents the proportion of the population who met criteria for SH in the past.…”

Risk of acute atherosclerotic cardiovascular disease in patients with acute and chronic pancreatitis

“…People have at least two-fold higher lifetime risk of developing diabetes after an attack of pancreatitis than those in the general population 25 . Both basic research and population-based study provide strong evidence suggesting that hypertriglyceridemia could be involved in the pathophysiology of acute ASCVD 20 , 27 , 28 . We considered that the effect of hypertriglyceridemia as the etiology of acute pancreatitis as well as a risk factors for severe disease and the potential link with cardiovascular disorders.…”

The Impact of Free Sugar on Human Health—A Narrative Review

“…It is well documented that coronary heart disease and cardiovascular diseases are related to hyperglycaemia and insulin resistance. Dyslipidaemia (particularly hypertriglyceridemia) and impaired insulin signalling are strongly associated with heart disease [ 151 , 152 , 153 , 154 ]. These conditions have commonly been found following long-term SSB consumption in large-scale human trials [ 19 , 22 , 23 , 155 ].…”