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In their recent article, Avins and Neuhaus¹ investigate whether high triglyceride levels contribute to the risk of coronary heart disease (CHD). Their conclusion is that triglyceride measurement does not provide a more useful evaluation of risk than an assessment of the subfractions that carry serum cholesterol. In the editorial discussion by Rubins,² she states that high and very high triglyceride levels should be treated. However, Rubins also asserts that when triglyceride levels are moderately elevated, clinicians should consider these elevations only as a marker for increased risk for CHD, not an indication for therapeutic intervention.

The significance of high triglyceride levels as a risk factor for CHD has long been debated. As early as 1959, Albrink and Mann³ published an article in the ARCHIVES regarding the association between serum triglyceride levels and risk for CHD; today, the role of hypertriglyceridemia in the causation of CHD has still not been clarified.

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