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Blood Lipids Ratio Plus Cardiovascular Fitness Levels May be Best Predictor of CHD Risk

Coronary heart disease is the leading cause of death for men in the United States. A recent study suggests that both cardiorespiratory fitness and blood triglyceride/high-density lipoprotein ratio (TG:HDL ratio) are strong predictors of the risk of death from coronary heart disease.


Participants in the study included 40,269 men who received a comprehensive physical exam between January 1, 1978, and December 31, 2010. The exam included a maximal treadmill exercise used to measure cardiorespiratory fitness as well as measurement of the blood triglyceride/high-density lipoprotein ratio (TG:HDL ratio).


The TG:HDL ratio is calculated by taking the fasting blood triglyceride level and dividing it by the blood HDL cholesterol level. A lower TG:HDL ratio indicates that insulin is working well, while a higher TG:HDL ratio indicates insulin resistance. A higher TG:HDL ratio also indicates a higher risk of pre-diabetes, type-2 diabetes, and cardiovascular disease.


The researchers placed the participants into one of three groups — low, moderate, or high — based on their cardiovascular fitness. They were also divided into quartiles based on their TG:HDL ratio. There was an average 16.6 years of follow-up, during which 556 participants died from coronary heart disease.


After examining the data, the researchers found that the fittest men in the lowest quartile of TG:HDL ratio had the lowest risk of death from coronary heart disease. The least fit men in the highest quartile of TG:HDL ratio had the highest risk. In all four TG:HDL ratio quartiles, the men with moderate to high levels of fitness had significant protection against cardiovascular heart disease, when compared with those with a low fitness level.


Researchers from The Cooper Institute in Dallas, Texas, conducted the study. It was published online ahead of print on November 17, 2017, in Mayo Clinic Proceedings.


The risk factors for coronary heart disease include being overweight or obese, high blood cholesterol, high blood pressure, diabetes, smoking and lack of physical activity. Lifestyle changes that may help lower the risk include losing weight, eating a heart healthy diet, quitting smoking, and performing exercise on a regular basis.

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