Hypertriglyceridemia natural history

Unclear Association of Hypertriglyceridemia with Atherosclerosis and Cardiovascular Events
It remains unclear if there is an independent association between hypertriglyceridemia and adverse cardiovascular outcomes. The ascertainment of any independent association between hypertriglyceridemia and clinical outcomes is confounded by the fact that hypertriglyceridemia is associated with so many atherosclerotic risk factors including obesity, diabetes and insulin resistance, metabolic syndrome, the presence of other dyslipidemias associated themselves both with high triglycerides and atherosclerosis (e.g. mixed hyperlipidemia, low HDL (hypoalphalipoproteinemia), Familial dysbetalipoproteinemia (type III hyperlipoproteinemia), etc.), high levels of small, dense LDL and finally  high levels of apolipoprotein B (apoB).

For example, the relationship among hypertriglyceridemia, atherosclerosis, and apoB is complex. Specifically, those forms of hypertriglyceridemia associated with high levels of apoB, but not those associated with low levels of apoB, are associated with atherosclerosis.

Pancreatitis
Hypertriglyceridemia can be associated with pancreatitis when the triglyceride levels are markedly elevated (i.e. when the triglyceride concentration is greater, and often very much greater, than 1000 mg/dl or 12 mmol/l).