The available data have suggested a significant association between hypertriglyceridemia and cardiovascular disease. Although atherogenic dyslipidemia in patients with metabolic syndrome is characterized by high triglyceride, low HDL cholesterol and near normal LDL cholesterol levels, lowering LDL cholesterol is the first priority in treating dyslipidemia in patients with metabolic syndrome. The use of statins as monotherapy is still leaving some of these patients with mixed atherogenic dyslipidemia at high risk for coronary events. So, it seems beneficial to add a fibrate to statin therapy in the management of dyslipidernia of metabolic syndrome, especially in patients with inadequately corrected triglyceride levels with statin monotherapy. (c) 2005 Elsevier Ireland Ltd. All rights reserved.