This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

John C. LaRosa, MD

Arch Intern Med. 1997;157(9):961-968.

Abstract
There seems little doubt that triglycerides are causally related to the progress of atherogenesis. Mechanisms for this effect include adverse quantitative and qualitative changes in circulating lipoproteins. In particular, the effects of lower high-density lipoprotein levels and the production by hypertriglyceridemia of small, dense low-density lipoproteins are of great significance. The role of triglyceride-rich remnant particles in atherogenesis is likely important. These remnants, which are lipoproteins rich in both cholesterol and triglycerides, can be shown to produce cholesteryl ester—laden macrophages in vitro and are probably atherogenic in vivo. Triglyceride levels are a significant risk factor for coronary artery disease in women, more so than in men. Triglyceride levels also increase in older patients and continue to be predictors of coronary risk in both men and women older than 65 years. It is unclear whether triglyceride intervention efforts should be directed at lowering triglyceride levels (such as is accomplished with niacin or fibric acid derivatives) or lowering low-density lipoprotein levels in patients with high triglyceride levels, assuming triglyceride levels are only a passive marker of atherosclerotic risk. Until more is known about the precise role of hypertriglyceridemia in atherogenesis in women and older patients, use of triglyceride-lowering drugs should be conservative and limited to those individuals with high triglyceride levels (>4.5 mmol/L [ >400 mg/dL]) who do not respond to diet modifications and who are at risk of coronary disease either because of a history of vascular disease or the presence of other risk factors.

Arch Intern Med. 1997;157:961-968

Author Affiliations
From the Office of the Chancellor, Tulane University Medical Center, New Orleans, La. Dr LaRosa is the recipient of occasional honoraria for Continuing Medical Education speeches at consultant meetings from Merck & Co, West Point, Pa, Bristol-Myers Squibb, Princeton, NJ, and Parke-Davis, Morris Plains, NJ.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Effect of Soy Nuts on Blood Pressure and Lipid Levels in Hypertensive, Prehypertensive, and Normotensive Postmenopausal Women
Welty et al.
Arch Intern Med 2007;167:1060-1067.
ABSTRACT | FULL TEXT  

Predictors of Carotid Intima-Media Thickness Progression in Young Adults: The Bogalusa Heart Study
Johnson et al.
Stroke 2007;38:900-905.
ABSTRACT | FULL TEXT  

Drug Treatment of Hyperlipidemia in Women
Walsh and Pignone
JAMA 2004;291:2243-2252.
ABSTRACT | FULL TEXT  

The effect of exemestane on serum lipid profile in postmenopausal women with metastatic breast cancer: a companion study to EORTC Trial 10951, 'Randomized phase II study in first line hormonal treatment for metastatic breast cancer with exemestane or tamoxifen in postmenopausal patients'
Atalay et al.
Ann Oncol 2004;15:211-217.
ABSTRACT | FULL TEXT  

A Randomized Trial of Low-Dose Tamoxifen on Breast Cancer Proliferation and Blood Estrogenic Biomarkers
Decensi et al.
JNCI J Natl Cancer Inst 2003;95:779-790.
ABSTRACT | FULL TEXT  

Multiple Lipoprotein Abnormalities Associated with Insulin Resistance in Healthy Volunteers Are Identified by the Vertical Auto Profile-II Methodology
Chu et al.
Clin. Chem. 2003;49:1014-1017.
FULL TEXT  

References
Circulation 2002;106:3373-3421.
FULL TEXT  

Risk factors for coronary heart disease: implications of gender
Roeters van Lennep et al.
Cardiovasc Res 2002;53:538-549.
ABSTRACT | FULL TEXT  

Primary Prevention of Coronary Heart Disease: Where Do We Go From Here?
Gotto
Arch Intern Med 2001;161:922-924.
FULL TEXT  

Cardiovascular Disease and Dyslipidemia in Women
Welty
Arch Intern Med 2001;161:514-522.
ABSTRACT | FULL TEXT  

Potential New Cardiovascular Risk Factors: Left Ventricular Hypertrophy, Homocysteine, Lipoprotein(a), Triglycerides, Oxidative Stress, and Fibrinogen
Harjai
ANN INTERN MED 1999;131:376-386.
ABSTRACT | FULL TEXT  

Use of hormone replacement therapy among cardiac patients at a Canadian academic centre
Wise et al.
CMAJ 1999;161:33-36.
ABSTRACT | FULL TEXT  

Effect of Moderate Alcohol Consumption on Hypertriglyceridemia: A Study in the Fasting State
Pownall et al.
Arch Intern Med 1999;159:981-987.
ABSTRACT | FULL TEXT  

Cardiovascular Disease in Women : A Statement for Healthcare Professionals From the American Heart Association
Mosca et al.
Circulation 1997;96:2468-2482.
FULL TEXT