cholesterol ratio can be achieved in such persons using gemiibrozil or nicotinic acid. For those with an isolated LDL cholesterol elevation, a hydroxymethylglutaryl coenzyme A Reductase inhibitor or a resin offer the greatest potential for improving the total/HDL cholesterol ratio.15 Small, dense triglyceride particles may be directly atherogenic, leading to cholesterol ester deposition. Also, elevated triglyceride levels are clearly components to Reaven’s Syndrome X which, along with insulm-resistance and low HDL, denotes accelerated atherogenesis. The size of the population at risk of CAD with unacceptable HDL cholesterol levels cannot be ignored and warrants a major clinical trial. Some 10% of the population have HDL cholesterol