Acta Med Scand 1985;217(5):481-9

Triglycerides--main lipid risk factor for cardiovascular disease in women?
Lapidus L, Bengtsson C, Lindquist O, Sigurdsson JA, Rybo E.

A 12-year longitudinal population study of 1462 women, aged 38-60, was carried out in Gothenburg, Sweden in 1968-69. Women with high initial serum triglyceride values had a higher 12-year incidence of myocardial infarction, stroke and total mortality than the others. The findings for serum triglycerides persisted for myocardial infarction, stroke and total mortality after adjustment for other possible risk factors for ischaemic heart disease such as age, systolic blood pressure, smoking, indices of obesity and serum cholesterol, while serum cholesterol did not predict any end-points studied when taking other risk factors including serum triglycerides into account.

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Ann Intern Med 1999 Sep 7;131(5):376-86

Potential new cardiovascular risk factors : left ventricular hypertrophy, homocysteine, lipoprotein(a), triglycerides , oxidative stress, and fibrinogen.

Harjai KJ.

Department of Cardiology, Ochsner Clinic, New Orleans, Louisiana 70121, USA. kharjai~ochsner.org

The 1996 Bethesda Conference acknowledged left ventricular hypertrophy, hyperhomocysteinemia, lipoprotein(a) excess, hypertriglyceridemia, oxidative stress, and hyperfibrinogenemia as possible new cardiac risk factors. This review summarizes the current literature that supports these conditions as cardiac risk factors. Left ventricular hypertrophy is an independent risk factor for vascular disease. Improvement or progression of left ventricular hypertrophy influences subsequent cardiovascular complications. Clinical trials are under way to assess the potential benefit of decreasing homocysteine levels. The role of lipoprotein(a) excess in vascular disease is controversial. The atherogenic potential of lipoprotein(a) seems to be neutralized by effective reduction of low-density lipoprotein cholesterol levels. Increasing evidence supports an independent role of hypertriglyceridemia in cardiovascular disease and a possible clinical benefit from decreasing triglyceride levels. Among antioxidant micronutrients, supplementation with vitamin E has been shown to be beneficial in primary and secondary prevention studies. Data supporting the use of other antioxidants are much weaker. Preliminary evidence suggests that reducing fibrinogen levels in patients with high baseline levels and coronary disease may be beneficial. Despite the potential relation between new risk factors and cardiovascular disease, routine clinical application of these conditions as cardiovascular risk factors would be premature. Evidence is needed that these conditions extend prognostic ability beyond conventional risk factors and that modification of these conditions can reduce the risk for cardiovascular events.