TRIGLYCERIDE CONCENTRATION AND ISCHEMIC-HEART-DISEASE - AN 8-YEAR FOLLOW-UP IN THE COPENHAGEN MALE STUDY

Background-The role of triglycerides as a risk factor of ischemic hear t disease (IHD) remains controversial. For the present study, we exami ned the relation between fasting triglycerides and risk of IHD in the Copenhagen Male Study. Methods and Results-Baseline measurements of fa sting lipids and other IHD risk factors were obtained for 2906 white m en (age range, 53 to 74 years) who were initially free of overt cardio vascular disease. During an 8-year follow-up period, 229 men had a fir st IHD event. Crude cumulative incidence rates of IHD were 4.6% for th e lowest, 7.7% for the middle, and 11.5% for the highest third of trig lyceride levels (P for trend <.001). Compared with the lowest third le vel and adjusted for age, body mass index, alcohol, smoking, physical activity, hypertension, non-insulin-dependent diabetes mellitus, socia l class, and LDL and HDL cholesterol, relative risks of IHD (95% confi dence interval) were 1.5 (1.0 to 2.3; P=.05) and 2.2 (1.4 to 3.4; P<.0 01) for the middle and highest third of triglyceride levels, respectiv ely. When triglyceride levels were stratified by HDL cholesterol level s (triglyceride third multiplied by HDL cholesterol third), a clear gr adient of risk of IHD was found with increasing triglyceride levels wi thin each level of HDL cholesterol, including high HDL cholesterol lev el, which are thought to provide protection against IHD. Conclusions-I n middle-aged and elderly white men, a high level of fasting triglycer ides is a strong risk factor of IHD independent of other major risk fa ctors, including HDL cholesterol.