Coronary heart disease in women: triglycerides and lipoprotein biology.

An examination of coronary heart disease in women over the past two decades in the United States reveals a disturbing gender difference that points to more treatment success in men than in women, which raises the question as to whether women have been as aggressively evaluated and treated. It is only over the last several years that evidence from randomized clinical trials on coronary heart disease etiology and treatment in women has become available. In addition, the previous widely held viewpoint that estrogen is cardioprotective and should be an integral part of pharmacologic therapy has been abandoned. Triglycerides and their very important influence on lipoproteins have emerged as a critical part of the pathobiological forces related to atherothrombosis in women.