Elevated total cholesterol and LDL cholesterol have been well established as risk factors for coronary heart disease (CHD). Several large clinical trials have demonstrated that lipid lowering decreases the incidence and mortality that results from CHD. However, a high percentage of subjects in these studies did not receive benefit from LDL lowering. Many experts believe that other lipid disorders may play a significant role in the atherogenic process, including elevated triglyceride levels alone or in association with a low level of HDL. Do elevated triglyceride levels pose an increased risk for CHD? This article describes the research done evaluating this question, as well as the influences of lifestyle changes and pharmacologic interventions on these dyslipidemias.