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The independent relationship between triglycerides and coronary heart disease

Authors Morrison A, Hokanson J

Published 23 October 2008 Volume 2009:5 Pages 89—95

DOI https://doi.org/10.2147/VHRM.S4311

Review by Single-blind

Peer reviewer comments 3


Alan Morrison1, John E Hokanson2

1SCRIBCO, Blue Bell, PA, USA; 2Department of Epidemiology, Colorado School of Public Health, University of Colorado at Denver Denver, CO, USA

Aims: 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).

Methods and 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.

Keywords: coronary heart disease, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, hypercholesterolemia

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