Atherosclerosis remains the number one cause of morbidity and mortality in most countries, including Malta. In spite of improved survival from coronary heart disease (CHD), due mainly to significant advances in interventional cardiology and coronary by-pass surgery, there is no good evidence that the incidence of atherosclerosis has significantly decreased.
The “dietary saturated fat, blood cholesterol and CHD” theory has prevailed and directed at lowering LDL-cholesterol (LDL). However, studies have shown that around of 50% of patients hospitalised with CHD are reported to have total-cholesterol (TC) and LDL levels within normal limits.
A study, comparing patients who had survived their first heart attack with matched patients without a history of CHD, found that those with the highest triglycerides (TRG)/HDL-cholesterol (HDL) ratios were 16 times more likely to have a heart attack than those with lower ratios. Other studies came to the same conclusion that the TRG/HDL ratio correlates strongly with the incidence and extent of Coronary Artery disease. This relationship is true both for men and women.
Indeed, the TRG/HDL ratio is the most predictive of all the routine blood lipid profiles. With the increasing prevalence of overweight, obesity and the metabolic syndrome this ratio becomes more important because high TRG and low HDL is often associated with these disorders.
Consequently, a low-carbohydrate with adequate protein and saturated and mono-saturated fat diet is the answer to control the TRG and HDL levels within the normal limits.
Clinipath, thus, are now reporting the risk ratio on the relationship of the TRG and HDL.
TRG/HDL Ratio Low Risk less 2.0
Moderate Risk 2.1 – 3.9
High Risk 4.0 – 6.0
Very high Risk over 6.0