Plasma triglycerides: a cardiovascular risk factor?

In a span of 3 decades, investigation as to whether elevated plasma triglyceride (TG) is associated with increased risk of coronary artery disease (CAD) produced results that have largely been inconsistent. Therefore, these investigations have been relegated to the background when compared to the significance give to cholesterol in the 80's. The first study to report an association between TG and myocardial infarction was in 1959. Since then, many other studies have been done starting from case control studies to prospective studies and then progressing to interventional studies. Many have found TG significant on a univariate but not on a multivariate analysis. Attempts have been made to analyse TG in diabetics, especially those with a normal cholesterol, in ischemic cerebrovascular disease (ICD), and in other disease states where atherosclerosis is involved in their pathogenesis. Of particular interest is that our studies in Taiwan have consistently showed that TG may indeed be an independent risk factor. Our subjects with ICD, CAD, and in different stages of hypertension, all had significant association with elevated TG. Statistical consider, i. e. discrepancy between univariate and a multivariate analysis, large variability of plasma TG distribution, as well as genetic susceptibility of certain individuals are also factors to be considered. No study to date has specifically been designed to evaluate TG lowering effects on primary prevention of CAD. Despite differences of opinion among the various authorities on this subject, I feel that the TG-CAD association should not be ignored and further intervention studies should be done.