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Hypertriglyceridemia and Atherosclerosis
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
IN RESPONSE:
Despite my attempts to portray the complexity the issue and, therefore, make physicians aware that treatment was not based on data as good as those for LDL Cholesterol, Dr. Avins obviously feels that my editorial was misdirected. In response to the major points of the letter: First, I omitted a very important recent paper from Hokanson and Austin [1] from my editorial. This meta-analysis convincingly demonstrated that triglyceride levels are independent predictors of future coronary artery disease in both men and women [1] and is more recent than either the 1989 or 1995 reports Dr. Avins coauthored.
Second, the central goal of my editorial was to provide physicians with insight into the complex metabolic abnormalities in lipoprotein that are associated with hypertriglyceridemia. The interaction data I mentioned support the view that hypertriglyceridemia is part of a potent atherogenic dyslipidemic state. Finally, although Dr. Avins states that niacin, statins, and gemfibrozil “are associated with serious side effects, great expense, or elevated risk for conditions other than coronary heart disease,” niacin is one of the least expensive medications available for the treatment of any disease and has been shown to reduce events and mortality [2]. In addition, the statins have been shown to be safe and to markedly reduce events and mortality [3, 4]. It is inappropriate and misleading to lump all of these drugs together in any blanket statement. Overall, I believe that my conclusions are based on both sound epidemiologic data and the availability of appropriate and efficacious therapies.
Henry N. Ginsberg, MD
College of Physicians & Surgeons of Columbia University; New York, NY 10032
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
