Don't be fooled by RATIOS like Triglycerides:HDL-C | Summary and Q&A

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June 5, 2023
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Don't be fooled by RATIOS like Triglycerides:HDL-C

TL;DR

Ratios like total cholesterol over HDL-cholesterol or triglycerides over HDL-cholesterol correlate with cardiovascular disease in population studies, but they are markers of risk rather than direct causes.

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Questions & Answers

Q: Do ratios like total cholesterol over HDL-cholesterol or triglycerides over HDL-cholesterol directly cause heart disease?

No, these ratios are markers of risk rather than direct causes of heart disease. They correlate with risk but don't actually cause it, as supported by evidence from randomized controlled trials and genetic data.

Q: Are higher levels of HDL-cholesterol protective against heart disease?

No, higher levels of HDL-cholesterol do not lower the risk of heart disease. HDL-cholesterol is a marker of other factors such as obesity, diabetes, liver disease, and smoking, but it is not protective on its own.

Q: Why do ratios like total cholesterol over HDL-cholesterol correlate well with risk in population studies?

Ratios combining markers like triglycerides and HDL-cholesterol can be good predictors of heart disease risk in population studies because they capture multiple risk factors. However, they may not be reliable on an individual level.

Q: Can positive changes like weight loss improve ratios and lower heart disease risk?

Positive changes like weight loss can reflect on the ratios, making them look better. However, having a good ratio does not guarantee lower heart disease risk because the components of the ratio can change without risk necessarily changing as well.

Summary & Key Takeaways

  • Ratios such as total cholesterol over HDL-cholesterol and triglycerides over HDL-cholesterol correlate with cardiovascular disease but are markers of risk, not actual causes.

  • HDL-cholesterol, despite its correlation with lower heart disease risk in population studies, is not protective when increased through genetics or medication.

  • Factors that directly modulate heart disease risk include glucose levels, smoking, ApoB, and blood pressure, among others.

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