Do Statins Lower Triglycerides?

Key Takeaways

Statins can help decrease triglyceride levels by 20 to 40% by lowering low-density lipoprotein (LDL) cholesterol levels and raising HDL (good cholesterol) levels.

High cholesterol is one of the major risk factors for developing heart disease and cardiovascular events like myocardial infarction (heart attack) and stroke.

For many people, lifestyle changes, such as a healthy diet and increased exercise, are not enough to bring cholesterol levels to a healthy range, and medications, such as statins, are necessary to keep their cholesterol level under control, thus lowering cardiovascular risk.

Statins help to lower LDL cholesterol, also called “bad” cholesterol, by up to 55% and reduce the risk of coronary heart disease.

Statins can also lower triglycerides but to a lesser extent, at 20 to 40% reduction.

Please continue reading to find out how statins affect triglyceride metabolism and how much improvement in elevated triglyceride levels patients treated with statin drugs can expect to have.

Do statins increase or lower triglycerides?

Statins do not increase triglycerides. Statin medication can help decrease triglyceride levels by up to 40%.

Note that statin drugs, also called HMG-CoA reductase inhibitors, mainly lower cholesterol by lowering low-density lipoprotein (LDL) cholesterol levels.

They do this by inhibiting cholesterol synthesis in the liver by blocking the activity of an enzyme called HMG-CoA (hydroxymethylglutaryl-CoA) reductase.

In addition, statin drug therapy also lowers triglyceride levels and raises HDL (high-density lipoprotein) cholesterol levels, also known as the “good” cholesterol.

While the effects of statins on the triglyceride level are not as significant as their effects on the LDL cholesterol level, the reduction is still promising at 20 to 40%. That is good news since high triglyceride levels can increase the risk of cardiovascular diseases, even if the LDL level is within the goal range.

What is the best statin for lowering triglycerides?

Studies have shown that the statins that are most effective in lowering LDL cholesterol are also the most effective for high triglycerides.

The FDA has approved 7 statins for lipid therapy in the United States. High doses and low doses of statins have the following effects:

High-intensity statins, such as atorvastatin (40 to 80 mg) or rosuvastatin (20 to 40 mg), can lead to a significant decrease in LDL cholesterol by more than 50%.
Medium-intensity statins, such as atorvastatin (10 to 20 mg), rosuvastatin (5 to 10 mg), fluvastatin (80 mg), lovastatin (40 mg), pravastatin (40 to 80 mg), simvastatin (20 to 40 mg), and pitavastatin (2 to 4 mg) can help in decreasing low density lipoprotein (LDL) cholesterol by 30 to 50%.
Low-intensity statins, such as fluvastatin (20 to 40 mg), lovastatin (20 mg), pravastatin (10 to 20 mg), simvastatin (10 mg), and pitavastatin (1 mg) decrease LDL cholesterol by less than 30% on average.

What is the best medicine to lower triglycerides?

While statin therapy is the most common and effective treatment in lowering LDL cholesterol and triglycerides, the following non-statin medications can be used alone or in various combinations to treat high triglycerides:

Fibrates such as clofibrate (Atromid-S), fenofibrate (TriCor, Lofibra, Fibricor), and gemfibrozil (Lopid).
Niacin or nicotinic acid (vitamin B3).
Icosapent ethyl (Vascepa), a highly purified form of EPA (an omega-3 fatty acid).
Prescription omega-3 fatty acids (Lovaza).
Over-the-counter omega 3 fatty acids (fish oil) supplements containing eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Your doctor will recommend trying healthy lifestyle changes, such as a diet low in refined carbohydrates with high fiber content, regular exercise, quitting smoking, and reducing alcohol use for the treatment of high triglycerides.

If these lifestyle measures are not successful in lowering your triglyceride levels, they may prescribe cholesterol-lowering medications.

What is the new drug to lower triglycerides?

New drugs that are being researched for high triglyceride levels include antisense oligonucleotides (ASOs) that contain pieces of DNA that short-circuit triglyceride formation in the liver.

ASOs are given by weekly injection and can lower triglyceride levels by up to 70%. However, these drugs are still being studied for safety and efficacy.

Larger and longer trials are needed to see what side effects they can cause and whether they reduce the risk of cerebrovascular disease.

How to manage high triglycerides naturally?

The National Cholesterol Education Program recommends the following to lower triglycerides naturally:

Get regular exercise
Maintain a healthy body weight
Avoid refined carbohydrates, trans and saturated fat
Quit smoking
Limit alcohol consumption
Get enough sleep
Manage stress
Mediterranean diet or DASH diet

What are triglycerides?

Triglycerides are a type of lipid (fat) in the blood. When you eat more calories than you burn, especially calories from refined carbohydrates, the body converts the extra calories into triglycerides and stores them in fat cells, from where they can be released when you need energy between meals.

Your healthcare provider can measure your plasma triglyceride level with a blood test called a lipid panel. Higher than normal levels are called hypertriglyceridemia.

A lipid profile also measures other types of cholesterol in the blood. Combined hyperlipidemia refers to elevated LDL cholesterol, VLDL cholesterol, triglycerides, and total cholesterol.

A normal triglyceride level is below 150 mg/dL. Triglyceride levels between 150 and 199 mg/dL are borderline high, and between 200 and 499 mg/dL are high. Levels above 500 mg/dL are very high triglyceride levels.

What is the link between triglyceride levels and cardiovascular disease?

Having a high triglyceride level can lead to narrowing and hardening of the walls of the blood vessels (this is called arteriosclerosis). This leads to an increased risk of coronary artery disease, heart attack, stroke, and peripheral arterial disease.

Very high triglyceride levels can lead to pancreatitis (acute inflammation of the pancreas).

Elevated triglycerides are frequently associated with other cardiovascular risk factors such as obesity, metabolic syndrome (high blood pressure, high blood sugar, high cholesterol, and excess fat around the waist), prediabetes, diabetes, and hypothyroidism (low thyroid hormone levels).

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