American Journal of Epidemiology Vol. 127, No. 6: 1118-1130
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
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RELATION OF TRIGLYCERIDE LEVELS TO CORONARY ARTERY DISEASE: THE MILWAUKEE CARDIOVASCULAR DATA REGISTRY
1Division of Biostatistics and Clinical Epidemiology, Department of Medicine, Medical College of Wisconsin P.O. Box 26509, Milwaukee, WI 53226
2Milwaukee Cardiovascular Data Registry, St. Luke's Hospital Milwaukee, WI
3Department of Pharmacology and Toxicology, Medical College of Wisconsin Milwaukee, WI
Reprint requests to Dr. David S. Freedman
Although levels of triglycerides have consistently shown a strong association with cardiovascular disease in both case-control and cohort studies, it remains controversial whether this relation exists independently of levels of cholesterol and other risk factors. The association of arteriographically documented coronary artery disease with plasma levels of triglycerides, total cholesterol, and high density lipoprotein (HDL) cholesterol was therefore examined in 5,216 white adults (81% were male) referred to two Milwaukee hospitals between 1972 and 1986. Elevated levels of triglycerides were related to the extent of coronary artery disease (estimated using the total number and severity of stenoses) In both sexes; this association existed independently of total cholesterol, age, obesity, hypertension, smoking, and alcohol consumption. In addition, the association between trlglycerides and coronary artery occlusion was strongest at total cholesterol levels 
250 mg/dl. However, both stratified and regression analyses Indicated there was no residual association between triglyceride levels and occlusion after controlling for HDL cholesterol. (Levels of HDL cholesterol and triglycerides showed a moderate Inverse association: r = –0.39 to –0.51.) These results indicate that the association between coronary artery occlusion and levels of triglycerides is indirect, and that the disparate findings of earlier studies may have resulted from not controlling for HDL cholesterol.
cholesterol; coronary disease; lipoproteins, HDL; triglycerides
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