Is Hypertriglyceridemia a Risk Factor for Atherosclerotic Cardiovascular Disease? A Simple Question with a Complicated Answer

Editorials1 June 1997Is Hypertriglyceridemia a Risk Factor for Atherosclerotic Cardiovascular Disease? A Simple Question with a Complicated AnswerHenry N. Ginsberg, MDHenry N. Ginsberg, MDCollege of Physicians and Surgeons of Columbia University, New York, NY 10032Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-11-199706010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The role of hypertriglyceridemia in the pathogenesis of atherosclerotic cardiovascular disease has been controversial for many years 1, 2. It remains so despite extensive investigation by basic scientists, clinicians, and epidemiologists. The lack of resolution of this issue derives mainly from the complexity inherent in the lipoprotein transport system 3. Although it is not possible to either unravel all of this complexity or resolve the controversy here, I attempt to provide a balanced review of the relevant literature, concluding with a suggested approach to the evaluation and treatment of the many patients who have elevated plasma triglyceride levels. I focus ...References1. Hully SB, Rosenman RH, Bawol RD, Brand RJ. Epidemiology as a guide to clinical decisions. The association between triglyceride and coronary heart disease. N Engl J Med. 1980; 302:1383-9. Google Scholar2. Austin MA. Plasma triglyceride and coronary heart disease. Arterioscler Thromb. 1991; 11:2-14. Google Scholar3. Ginsberg HN. Lipoprotein metabolism and its relationship to atherosclerosis. Med Clin North Am. 1994; 78:1-20. Google Scholar4. Hamsten A. Hypertriglyceridemia, triglyceride-rich lipoproteins and coronary heart disease. Baillieres Clin Endocrinol Metabol. 1990; 4:895-922. Google Scholar5. Daugherty A, Lange LG, Sobel BE, Schonfeld G. 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Circulation. 1992; 85:37-45. Google Scholar18. Assmann G, Schulte H. Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PRO-CAM experience). Prospective Cardiovascular Munster Study. Am J Cardiol. 1992; 70:733-7. Google Scholar19. Despres JP, Lamarche B, Mauriege P, Cantin B, Dagenais GR, Moorjani S, et al. Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med. 1996; 334:952-7. Google Scholar20. Wilt TJ, Rubins HB, Collins D, O'Connor TZ, Rutan GH, Robins SJ. Correlates and consequences of diffuse atherosclerosis in men with coronary heart disease. Veterans Affairs High-Density Lipoprotein Intervention Trial Study Group. Arch Intern Med. 1996; 156:1181-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: College of Physicians and Surgeons of Columbia University, New York, NY 10032Grant Support: By grants HL21006, HL55638, and RR00645 from the National Institutes of Health.Corresponding Author: Henry N. Ginsberg, MD, Division of Preventive Medicine and Nutrition, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032. 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Primary preventionA Frequent Mutation in the Lipoprotein Lipase Gene (D9N) Deteriorates the Biochemical and Clinical Phenotype of Familial HypercholesterolemiaActivation of the Contact System of Coagulation Does Not Contribute to the Hemostatic Imbalance in HypertriglyceridemiaDrug Treatment of Lipid DisordersGemfibrozil for the Secondary Prevention of Coronary Heart Disease in Men with Low Levels of High-Density Lipoprotein CholesterolElevated Serum Triglyceride Levels and Long-Term Mortality in Patients With Coronary Heart DiseasePostprandial dyslipidaemia in a nutshell: food for thought 1 June 1997Volume 126, Issue 11Page: 912-914KeywordsAtherosclerotic cardiovascular diseaseBlood plasmaCholesterolEpidemiologyHigh density lipoproteinLipoproteinsLow density lipoproteinMedical risk factorsNiacinVery low density lipoprotein Issue Published: 1 June 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...