The Study
High triglyceride to HDL cholesterol ratio is associated with increased coronary heart disease among White but not Black adults
This study watched a bunch of people over many years and noticed that when some health numbers were high, heart problems happened more often — but it didn’t change anything on purpose. So we can say these numbers are linked to heart disease, but we can’t say they cause it.
Analysis score
Maximum 72 for a cohort study.
Where the score came from
Doctors often check a ratio of two fats in the blood to guess heart attack risk, but this study found it only works well for White adults—not Black adults.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 567 / 100
Quality score
Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes—this means inflammation is a reliable warning sign for everyone, but the fat ratio isn't useful for Black adults, so relying on it could miss their real risk.
- 2In White adults: high fat ratio = 44% higher heart attack risk; high inflammation = 68% higher risk; both together = 84% higher risk.
- 3In Black adults: high fat ratio = no extra risk; high inflammation = 43% higher risk; both together = 52% higher risk.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
American Journal of Preventive Cardiology
Year
2021
Authors
C. H. Tejera, J. Minnier, S. Fazio, M. Safford, Lisandro D. Colantonio, M. Irvin, V. Howard, N. Zakai, N. Pamir
Related Content
Claims (6)
People with a higher ratio of triglycerides to HDL cholesterol have a greater likelihood of developing cardiovascular disease.
In adults aged 45 and older, a high ratio of triglycerides to HDL cholesterol is linked to a 44% higher risk of coronary heart disease in White individuals but not in Black individuals.
Adults aged 45 and older with higher levels of high-sensitivity C-reactive protein have a 43–68% greater chance of developing coronary heart disease, regardless of their triglyceride-to-HDL cholesterol levels.
In Black adults aged 45 and older, the ratio of triglycerides to HDL cholesterol does not indicate the risk of coronary heart disease, even when accounting for other known risk factors like blood pressure and smoking.
Adults with both high triglyceride-to-HDL cholesterol ratios and high levels of hsCRP have a higher risk of coronary heart disease than those without these markers, with the risk increase being 84% in White adults and 52% in Black adults, and the combined effect is simply additive.
In adults aged 45 and older, high-sensitivity C-reactive protein measures inflammation and predicts coronary heart disease risk more accurately than the triglyceride-to-HDL cholesterol ratio, and inflammation is the main factor driving risk when both biomarkers are considered together.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.