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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Triglycerides and cardiovascular risk

Circulation has published the results of a study that aimed to quantify the association between raised triglyceride levels and the risk of coronary heart disease (CHD).

The study found that there was a correlation between raised triglyceride levels and the risk of CHD but also found that after adjusting for established risk factors (including blood pressure and total cholesterol) that the association was substantially attenuated.

The study examined data from two prospective case-control studies and also updated a meta-analysis. Comparisons of the top and bottom terciles revealed adjusted odds ratios as follows:

  • Reykjavik study - Odds ratio 1.76 [95% CI, 1.39 to 2.21]
  • EPIC-Norfolk study - Odds ratio 1.57 [95% CI, 1.10 to 2.24]
  • Meta-analysis - Odds ratio 1.72 [95% CI, 1.56 to 1.90]

The study concludes that there are moderate and statistically significant associations between triglyceride levels and CHD risk but that, "these associations depend considerably on levels of established risk factors". The authors recommend that more research needs to be carried out to investigate the nature of any independent associations.

Action: Well-established CHD risk assessment tools should be used to guide treatment decisions. Elevated triglyceride levels may inform the risk assessment process but should not be used alone in estimating CHD risk.

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