The independent relationship between triglycerides and coronary heart disease.
OBJECTIVE
The aim was to review epidemiologic studies to reassess whether serum levels of triglycerides should be considered independently of high-density lipoprotein-cholesterol (HDL-C) as a predictor of coronary heart disease (CHD).


RESULTS
We systematically reviewed population-based cohort studies in which baseline serum levels of triglycerides and HDL-C were included as explanatory variables in multivariate analyses with the development of CHD (coronary events or coronary death) as dependent variable. A total of 32 unique reports describing 38 cohorts were included. The independent association between elevated triglycerides and risk of CHD was statistically significant in 16 of 30 populations without pre-existing CHD. Among populations with diabetes mellitus or pre-existing CHD, or the elderly, triglycerides were not significantly independently associated with CHD in any of 8 cohorts. Triglycerides and HDL-C were mutually exclusive predictors of coronary events in 12 of 20 analyses of patients without pre-existing CHD.


CONCLUSIONS
Epidemiologic studies provide evidence of an association between triglycerides and the development of primary CHD independently of HDL-C. Evidence of an inverse relationship between triglycerides and HDL-C suggests that both should be considered in CHD risk estimation and as targets for intervention.
Morrison
Alan
A
SCRIBCO, Blue Bell, PA, USA.
Hokanson
John E
JE
D015415:Biomarkers / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D015536:Down-Regulation; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D018570:Risk Assessment; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D015854:Up-Regulation
D015415:Biomarkers; D008076:Cholesterol, HDL; D014280:Triglycerides