LDL-cholesterol subfractions have a different atherogenity; the most atherogenic are small LDL3 called small dense LDL. A clear relationship was proved between their concentration and early manifestation of ischaemic heart disease. In some instances they were found to act as an inde- pendent risk factor of cardiovascular disease. Their concentration depends to a great extent on the triacyglycerol concentration. They are found most frequently in patients with combined hy- perlipidaemia , in associated metabolic syndrome and in patients with type 2 diabetes mellitus. Their plasma concentration can be reduced by non-pharmacological methods (restriction of ani- mal fats, reduction of body weight, physical activity) as well as by pharmacological means ( in particular fibrates). Micronized phenofibrate reduces significantly the concentration of small LDL3 and thus contributes to normalization of dyslipoproteinaemia and reduction of the risk of cardiovascular complications.

        Key words: Low density lipoproteins - Small density LDL - Cardiovascular diseases - Phenofibrate.