Author Affiliations: Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison.
Evidence that elevated serum triglyceride levels are associated with increased risk for atherosclerotic events is increasing. In this issue of JAMA, 2 large, long-term prospective cohort studies conducted in different populations by Bansal and colleagues1 and by Nordestgaard and colleagues2 support the role of nonfasting triglyceride levels as a significant risk factor for coronary heart disease (CHD) events. However, a high serum triglyceride level is associated with abnormal lipoprotein metabolism, as well as with other CHD risk factors including obesity, insulin resistance, diabetes mellitus, and lowered levels of high-density lipoprotein cholesterol (HDL-C).3 When determining CHD risk, how important is it to know which came first—high serum triglyceride levels or the risk factors that cause high levels?
McBride PE. Triglycerides and Risk for Coronary Heart Disease. JAMA. 2007;298(3):336–338. doi:10.1001/jama.298.3.336