Even with statins, high triglycerides may increase risk of second stroke | 即使使用他汀類藥物,高甘油三酯也可能增加二次中風的風險

Editor’s note:  The claim that high triglycerides may increase risk of second stroke may be misleading.  Be aware that not all triglycerides are as harmful as thought.  Some are actually beneficial.  Three things you need to know regarding lipids.  Trans fat, saturated fat and omega6/omega 3 fat.
Trans fat is partially hydrogenated fat which can also be formed during thermal processing of foods.  So even if no trans fat is added to a food, the food can potentially contain trans fat if the food contain polyunsaturated fat which can transform to become trans fat.  Food chemists know this.
Saturated fat can exist in solid form in the blood stream.  Whether or not saturated fat exist in solid form depends on the blood condition.  Solid form saturated fat is a risk for stroke and also diabetes, maybe cancer too.  Solid form saturated fat or fatty acids can mess up all sorts of enzyme activities.  That is why high saturated and trans fat is linked to elevated risk of diabetes.
Omega 6 fatty acids can be beneficial.  But too much of them can be a risk factor of inflammation.  Omega 3 fatty acids can neutralize the negative impact of omega 6 fatty acids. That is why the ratio of omega 6 to omega 3 fatty acids is important.
Remember that too fat or high triglycerides can be bad for your health.  This is a complicated issue.  You do not have to eat processed cooking oil for your life.  Eating processed oil can sabotage your health.

編者註:高甘油三酯可能會增加二次中風風險的說法可能具有誤導性。請注意,並非所有甘油三酯都像想像的那樣有害。有些實際上是有益的。關於脂質你需要知道的三件事。反式脂肪、飽和脂肪和 omega6/omega 3 脂肪。

反式脂肪是部分氫化脂肪,也可以在食品的熱處理過程中形成。因此,即使食物中沒有添加反式脂肪,如果食物中含有可轉化為反式脂肪的多不飽和脂肪,該食物也可能含有反式脂肪。食品化學家知道這一點。

飽和脂肪可以固體形式存在於血流中。飽和脂肪是否以固體形式存在取決於血液狀況。固體形式的飽和脂肪是中風和糖尿病的風險,也可能是癌症。固體形式的飽和脂肪或脂肪酸會破壞各種酶的活性。這就是為什麼高飽和脂肪和反式脂肪與糖尿病風險升高有關。

歐米茄 6 脂肪酸可能是有益的。但它們中的太多可能是炎症的危險因素。歐米茄 3 脂肪酸可以中和歐米茄 6 脂肪酸的負面影響。這就是為什麼歐米茄 6 與歐米茄 3 脂肪酸的比例很重要的原因。

請記住,過多的脂肪或高甘油三酯可能對您的健康有害。這是一個複雜的問題。您不必終生食用加工過的食用油。食用加工過的油會破壞您的健康。

NEWS RELEASE 

Peer-Reviewed Publication

AMERICAN ACADEMY OF NEUROLOGY

MINNEAPOLIS – Stroke can have many causes. An atherothrombotic stroke is caused by a clot that forms from plaques that build up within blood vessels in the brain. A new study suggests that people who have this type of stroke who also have higher levels of triglycerides, a type of fat, in their blood may have a higher risk of having another stroke or other cardiovascular problems one year later, compared to people who had a stroke but have lower triglyceride levels. The research is published in the March 16, 2022, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study found an association even when people were taking statin drugs meant to lower triglycerides and protect against heart attack and stroke.

Elevated triglyceride levels are thought to contribute to hardening of the arteries and increased risk of heart attack, heart disease and stroke.

“Our study suggests that for people who had atherothrombotic stroke, having elevated levels of triglycerides in their blood is a risk factor for having another stroke or other cardiovascular problems in the future, and we found that to be true even if the person is on statin therapy,” said study author Takao Hoshino, MD, of the Tokyo Women’s Medical University in Japan. “The good news is that statin medications are just one therapy for high triglycerides—diet and exercise can also be effective ways to reduce the levels in your blood at little or no cost.”

The study looked at 870 people who had a stroke or transient ischemic attack. Their average age was 70. Of those, 217, or 25%, had elevated triglyceride levels, defined as fasting triglycerides levels 150 milligrams per deciliter or higher.

Researchers followed up with the participants one year later to find out if there was an association between high triglyceride levels and having another stroke, acute coronary syndrome, which is any condition caused by a sudden reduction of blood flow to the heart, or death due to vascular causes.

After adjusting for factors like cholesterol level and statin use, researchers found that people who had high triglyceride levels had a 21% greater risk of death, stroke or heart condition one year, compared to 10% greater risk for those with lower levels.

When researchers looked specifically at people who had another stroke after an atherothrombotic stroke, they found that 14 out of 114 people with normal triglyceride levels, or 12%, had one during the study, compared to 33 out of 217 people, or 16%, of those with elevated levels.

For acute coronary syndrome, one out of 114 people, or 0.9%, with normal triglyceride levels developed the heart condition one year after an atherothrombotic stroke, compared to five out of 60, or 8%, of those with elevated levels.

Hoshino notes the study did not find an association between higher triglyceride levels and future cardiovascular problems in people who had a different type of stroke called cardioembolic stroke.

“More research is needed, but for people who have had an atherothrombotic stroke, triglyceride levels may emerge as a key target for preventing future strokes and other cardiovascular problems,” Hoshino said. “Statin therapy is still an effective treatment for people with high triglyceride levels, but our study highlights how important it is to look at all the tools a person can use to lower their triglycerides, including diet modifications, exercise and taking omega-3 fatty acids.”

The study does not prove that lowering high triglyceride levels will prevent people with atherothrombotic strokes from having cardiovascular problems later; it only shows an association.

A limitation of the study is that researchers considered only the participants’ fasting levels of triglycerides.

Learn more about stroke at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on FacebookTwitter and Instagram.

When posting to social media channels about this research, we encourage you to use the hashtags #Neurology and #AANscience.

The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 38,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit AAN.com or find us on FacebookTwitterInstagramLinkedIn and YouTube.


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