Triglyceride metabolism is complex and still poorly understood. Hypertriglyceridemia seems to enhance the risk for the development of coronary heart disease, but it cannot be regarded as a counterpart of hypercholesterolemia as a risk factor. The relevance of reduction of triglycerides in the prevention of coronary heart disease is still unclear. This is related to a number of problems, such as the lack of adequate clinical trials, heterogeneity in the abnormalities of triglyceride metabolism and unknown atherogenic threshold levels for serum triglycerides. Curr Opin Lipidol 9:571–574. © 1998 Lippincott Williams & Wilkins