Stroke survivors may be concerned about their "bad" cholesterol, but a new study reveals that another form of blood fat may put them at risk of having another stroke within the year.
Stroke survivors with high triglycerides had twice the likelihood of repeat strokes as survivors with normal triglyceride levels, according to researchers. Even if they were using cholesterol-lowering statin medicines, their risk of heart attack and severe chest discomfort was increased. However, doctors say it’s unclear whether excessive triglycerides were the cause.
Dr. Leah Dickstein, a clinical assistant professor of neurology believes they could simply be a symptom of something else going on.
“We don’t know that treating high triglycerides will lower these risks,” said Dickstein, who was not involved in the study.
The good news is that many of the things that are typically suggested to stroke survivors will also help them manage their triglycerides, she said. A diet low in saturated fat and processed carbohydrates, frequent physical activity, and abstaining from alcohol are among them.
Although LDL (“bad”) cholesterol receives the most of the attention, triglycerides are another type of blood fat that can rise when people are overweight, consume too many calories and consume too much alcohol. Obesity, type 2 diabetes, renal disease, and high blood pressure are all associated with high triglycerides levels. High triglycerides, on the other hand, haven’t been proven to predict a worse prognosis for stroke survivors.
Dr. Takao Hoshino and colleagues followed 870 patients at their hospital for the new study. All of them had experienced a stroke or a “mini-stroke” recently. One-quarter of the participants had high triglycerides at the start, defined as 150 mg/dL or greater. Those individuals had more serious “cardiovascular events” in the following year than stroke survivors with normal triglyceride levels.
Approximately 16 percent of patients with high triglycerides experienced a second stroke, compared to just 8% of those with normal triglycerides. Meanwhile, 4 percent of those with high triglycerides suffered a heart attack or chest pain due to limited blood flow to the heart, compared to less than 1% of those with normal triglycerides, according to the study.
Other risks, such as obesity, diabetes, and kidney disease, were taken into account by the researchers. High triglycerides were still connected to an increased risk of recurrent stroke or heart disease. This was true whether or not the individuals were on cholesterol-lowering statins.
However, another neurologist in the United States stated that elevated triglycerides may not be the obvious reason.
Other, unmeasured factors may have contributed to the elevated risks, according to Dr. Larry Goldstein, a volunteer expert with the American Heart Association.
Furthermore, the research was conducted at a single medical site in Japan, and the results may not apply to patients in other parts of the world, according to Goldstein. It’s different in Japan, he explained. Strokes are frequently linked to hardened, restricted arteries within the brain in Japan, he explained. Stroke patients in Western countries are more likely to have problems in the neck arteries that carry blood to the brain, according to Goldstein. However, both neurologists agreed that elevated triglycerides require attention.
According to Goldstein, triglycerides are evaluated as part of a conventional “lipid panel” that assesses cholesterol levels. If they’re high, he recommends taking another test – this time following an overnight fast, because meals impact triglyceride levels.
“I don’t think patients should panic over a single number,” Dickstein stressed.
Instead, she said, people with high triglycerides can focus on the lifestyle changes that will not only help with that issue, but benefit their overall health.
People with excessive triglycerides may require special medicine, according to Dickstein. Niacin, Fibrate medicines and prescription-grade fish oil are among the choices. However, further research is needed to confirm that lowering triglycerides reduces the risk of stroke. People with high triglycerides should talk to their doctor about the different ways they might lower their risk of cardiovascular disease, according to Goldstein.
Parvathy Sukumaran 
