How important is my triglyceride level?
Your triglycerides are a meaningful risk indicator, especially in combination with abdominal fat or a high blood sugar level. Lifestyle changes lower them effectively; if you also have elevated cholesterol, discuss with your doctor whether EPA supplementation is right for you.
Triglycerides are more than just a number on your blood test results. They are part of the fat particles that your blood carries, and those particles can build up in your arteries and cause inflammation. That process contributes to atherosclerosis, even when your LDL cholesterol ('bad' cholesterol) is already well under control. In other words: even people who are already taking cholesterol-lowering medication can still face additional risk from high triglycerides.
Exactly how high that risk is depends not only on your triglycerides themselves, but also on the combination with other factors. A useful measure is the ratio of triglycerides to your HDL cholesterol ('good' cholesterol). When that ratio is high, your chance of cardiovascular disease rises by about 31% per unit increase. Another measure combines triglycerides with your fasting blood sugar; per unit increase, the risk rises by approximately 18%. These are modest but statistically reliable associations observed across thousands of people.
Abdominal fat makes the combination particularly dangerous. In research, people with a large amount of fat around their organs and high triglyceride-related values had a risk of cardiovascular disease that was 75 to 87% higher than people without this combination. Frail older adults with high triglycerides and declining physical functioning showed even higher figures in one large study, though overall health plays a major role there as well.
What can you do about it yourself? Triglycerides respond well to lifestyle changes: eating less sugar and refined carbohydrates, drinking less alcohol, exercising more, and losing weight all demonstrably lower them. Research suggests that people who are already taking a statin but still have high triglycerides may benefit from EPA, a specific omega-3 fatty acid (the type found in fish oil). This has been shown not only to lower triglycerides, but also to reduce the number of cardiovascular events. Standard fish oil capsules containing a mixture of fatty acids have not, however, demonstrated that effect; discuss this with your doctor if you are considering it.
All findings are based on observational cohort studies and review articles (PMID 40065297, 33257928, 31504418, 39856691, 39604987, 39113004, 39920683, 40759963). There are no randomised trials in the source for the TyG or AIP measurements themselves; the causal direction for triglyceride-rich lipoproteins is probable but not proven. The EPA effect is derived from one review source and not from a direct RCT in this source document.
Is a calcium score of my heart worth doing?
For people aged 40 to 75 in a grey zone regarding statins, a calcium score is a well-supported tool for making a considered decision about medication together with your doctor.
What is a healthy cholesterol level and when should I be concerned?
A normal LDL value does not give a complete picture of your cardiovascular risk. Ask your doctor about your remnant cholesterol as well, especially if cardiovascular disease or Alzheimer's disease runs in your family.
How often should I measure my blood pressure at home, and what is normal?
Measuring at home gives a more reliable picture than a single reading at the doctor's office: measure at least seven days, twice a day, and use 135/85 mmHg as the upper limit of normal. Fluctuations and consistently elevated values are just as important as the average.
Does losing weight noticeably improve my blood pressure and cholesterol?
Losing weight noticeably lowers your blood pressure and improves your cholesterol profile, but which value improves the most depends on your diet. And if the weight comes back, most of the gains disappear along with it.
Do omega-3 (fish oil) supplements benefit my heart?
Fish oil has a modest, proven effect on triglycerides and possibly slightly fewer heart attacks, but does not demonstrably reduce the overall risk of death. If you already have heart problems or are at high risk, it is worth discussing with your doctor.
Does taking omega-3 help you stay healthy for longer?
Omega-3 reliably lowers your blood fats, but has not yet been proven to make you live longer or healthier. If you already have heart disease, discuss with your doctor whether omega-3 is a worthwhile addition to your treatment.