Triglyceride Levels: What the Numbers Mean for Heart Health

You may already be familiar with cholesterol, but triglycerides deserve equal attention. These blood fats are a commonly overlooked component of routine blood work. Yet, they significantly impact your heart health.

“We see patients who are overly reassured that their LDL cholesterol looks fine, but it’s ignored that their triglycerides are high,” says Romit Bhattacharya, MD, a general and preventive cardiologist with the Mass General Brigham Heart and Vascular Institute. “Then, when they develop heart disease, they’re often quite confused,” he adds.

What are triglycerides?

Triglycerides are a type of fat (lipid) that circulates in your bloodstream. Unlike cholesterol, a waxy fat-like substance your body produces naturally, triglycerides mainly come from food. They’re formed both from the fats and carbohydrates you eat and from extra calories that your liver converts into fat for storage.

After a meal, your body packages this energy into triglycerides so it can travel through the bloodstream to your muscles and other tissues. There, triglycerides are broken down into fatty acids and glycerol for energy. Any excess gets stored in fat tissue and released later when energy is needed.

The health risks of high triglycerides

Problems arise when your body’s processing system becomes overwhelmed. “If too many triglycerides are being produced or if the clearance system isn’t working properly, then these particles will linger in the bloodstream,” Dr. Bhattacharya says.

When triglycerides accumulate in your blood, they begin damaging your cardiovascular system. “Over time, the remnants of those triglycerides, which are very cholesterol-rich, get into the artery walls,” Dr. Bhattacharya says. This causes the arteries to narrow—a condition called atherosclerosis.

High triglycerides and their buildup can have serious health consequences. These include:

• Heart attack
• Heart disease
• Pancreatitis (inflammation of the pancreas)
• Stroke

Understanding triglyceride blood test results

Blood lipid tests measure triglycerides along with cholesterol. Your provider asks you not to eat for several hours before the test to ensure the most accurate results possible.

The test tells you the amount of fat in your blood and helps your doctor assess your cardiovascular risk. A normal triglyceride level falls below 150 mg/dL. Your doctor diagnoses you with high triglycerides if your levels are regularly higher.

Triglyceride levels are further separated into categories, which indicate your risk of health complications:

• Borderline high and high: Triglycerides that stay higher than 175 mg/dL increase your risk for heart disease and stroke.
• Very high: If your levels are greater than 500 mg/dL, you add the risk of acute pancreatitis. This sudden inflammation of the pancreas causes severe abdominal pain and may require hospital treatment.
• Extremely high: Triglyceride levels greater than 1,500 mg/dL can cause your body to shut down fat digestion. This can lead to pancreatitis.

Your cholesterol levels also factor into overall cardiovascular risk. A healthy total cholesterol level sits around 150 mg/dL, while anything above 200 mg/dL is considered high.

Next steps to lower triglycerides

If your triglyceride levels are high, your doctor works with you to create a treatment plan. They may recommend starting with lifestyle changes, such as regular exercise, a balanced diet, and weight loss.

These changes may be enough to lower your triglycerides to a healthy level and avoid the need for medication. Dr. Bhattacharya typically prescribes medication to people who’ve developed atherosclerosis or those who have a health condition that increases their heart attack risk, such as diabetes.

Track triglyceride levels for a healthy heart

Regular doctor visits are crucial for maintaining heart health. “Cardiovascular disease takes many decades to develop,” Dr. Bhattacharya says. By monitoring your triglyceride and cholesterol levels, you and your doctor can address any issues before damage occurs.

Experts recommend checking triglyceride and cholesterol levels every five years in healthy adults. Older adults, individuals with high blood lipids, and those with heart disease risk factors may require more frequent testing to monitor their condition.