High triglycerides and cholesterol: Cardiologist explains why this combination is dangerous for heart

Most of us have heard about cholesterol, but triglycerides often do not get the same attention until a blood test flags them. Both are types of fats (lipids) found in your blood, and keeping them in check is essential for heart health. According to global health data, high cholesterol alone contributes to millions of heart disease cases every year. But when high cholesterol combines with high triglycerides, the risk becomes even more serious.

According to Dr V.P. Sharma, Director and Senior Consultant Cardiology, understanding the difference between these two and monitoring your levels regularly can help prevent long-term heart complications.

Triglycerides vs cholesterol: What is the difference?

While both are lipids, they serve very different functions in the body.

• Triglycerides are your body’s way of storing extra energy. When you consume more calories than you burn, especially from sugars and refined carbs, the excess is converted into triglycerides and stored as fat.
• Cholesterol, on the other hand, is a waxy substance produced by the liver. It helps build cells, produce hormones, and aid digestion. Unlike triglycerides, it is not used for energy.

Think of triglycerides as stored fuel and cholesterol as a building material, both necessary but harmful in excess, says Dr Sharma.

Why can high levels be dangerous?

Having high levels of either triglycerides or cholesterol can harm your heart, but in different ways.

• High triglycerides are linked to conditions like fatty liver, pancreatitis, and increased cardiovascular risk. A study published in the Current Atherosclerosis Reports found that people with high triglyceride levels had nearly double the risk of heart disease.
• High cholesterol, especially LDL (bad cholesterol), leads to plaque buildup in arteries, a condition known as atherosclerosis. This restricts blood flow and increases the risk of heart attack and stroke.

Dr Sharma highlights that the real concern arises when both triglycerides and LDL cholesterol are high or HDL (good cholesterol) is low. This combination significantly accelerates heart damage.

Good vs bad cholesterol: What you should know

Not all cholesterol is harmful.

• LDL (Low-Density Lipoprotein): Known as bad cholesterol, it contributes to plaque buildup.
• HDL (High-Density Lipoprotein): Known as good cholesterol, it helps remove excess fat from the bloodstream.

Low HDL levels can increase heart risk, while lower LDL levels are generally beneficial.

Know your numbers: What is considered normal?

Knowing your lipid levels is essential for early prevention.

Triglycerides:

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• Normal: Less than 150 mg/dL
• High: 200–499 mg/dL
• Very high: 500+ mg/dL

Cholesterol:

• LDL (bad): Ideally below 100 mg/dL
  HDL (good): Above 40 mg/dL in men, 50 mg/dL in women

The American Heart Association recommends regular screening, as levels can rise silently without symptoms.

Why are high triglycerides and cholesterol together risky?

When both triglycerides and LDL cholesterol are high, it creates a double burden on your heart. Triglycerides can thicken the blood and affect metabolism, while LDL cholesterol blocks arteries. Together, they significantly increase the risk of heart attack, stroke, and poor blood circulation. Research published in Lipids in Health and Disease also links high triglycerides to increased mortality risk, highlighting the importance of early management.

Common causes behind high levels

Lifestyle plays a major role in raising both triglycerides and cholesterol. Common triggers include:

• High sugar and refined carbohydrate intake
• Processed and fried foods
• Lack of physical activity
• Smoking and alcohol consumption
• Obesity and uncontrolled diabetes

Genetics and ageing can also contribute to higher levels.

How to lower triglycerides naturally?

Managing triglycerides mainly involves controlling calorie intake:

• Cut down on sugar and refined carbs
• Limit alcohol consumption
• Exercise regularly
• Maintain a healthy weight
• Include whole grains, fruits, and vegetables

How to reduce cholesterol levels?

Lowering cholesterol requires a slightly different approach:

• Reduce intake of saturated fats (red meat, full-fat dairy)
• Avoid trans fats and processed foods
• Increase fibre intake (oats, fruits)
• Quit smoking
• Stay physically active

Medication may be needed in some cases, as advised by a doctor.

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