How important are triglycerides as risk factors?

For more than 30 years, mild-to-moderate hypertriglyceridemia was considered along with hypercholesterolemia as a risk factor for cardiovascular disease, whereas severe hypertriglyceridemia has been a well known risk factor for acute pancreatitis. Following the discovery of the receptor for LDL and the publication of the first studies on the use of the statins, the interest of the research community has been focusing more on the lipoproteins, relegating hypertriglyceridemia to a secondary role. Furthermore, the elevation of triglycerides is strictly related to the reduction of the blood level of HDL, and accordingly conventional thinking has been to consider hypertriglyceridemia as a nonindependent risk factor for cardiovascular events. To add to this concept is the lack of firm evidence of efficacy of the drugs intended to reduce blood level of triglycerides (fibrates, niacin and Omega-3). In the last few years, though, new elements became available to further clarify the relationship between triglycerides and cardiovascular diseases.