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

Henry N. Ginsberg, MD
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College of Physicians and Surgeons of Columbia University, New York, NY 10032 Grant Support: By grants HL21006, HL55638, and RR00645 from the National Institutes of Health. Requests for Reprints: 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.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;126(11):912-914. doi:10.7326/0003-4819-126-11-199706010-00012
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The role of hypertriglyceridemia in the pathogenesis of atherosclerotic cardiovascular disease has been controversial for many years [12]. 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 on the lipid aspects of this issue, but it should not be forgotten that elevated triglyceride levels have been associated with several abnormalities of the clotting-fibrinolytic systems [4].

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