Current Status of Lipid Management of Hypertensive Patients

Matsubara, Koichi; Yamamoto, Yorihiro; Sonoyama, Kazuhiko; Igawa, Go; Furuse, Masahiro; Yatsuhashi, Toru; Hamada, Toshihiro; Oginö, Kazuhíde; Igawa, Osamu; Hisatome, Ichiro; Shigemasa, Chiaki

doi:10.1291/hypres.26.699

Cited by 13 publications

(7 citation statements)

References 35 publications

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“…5,24 Similarly, in a Japanese study, 25 a review of the profiles of 830 hypertensive patients revealed a diagnosis of hyperlipidaemia in more than 45%. Of these, less than 65% were on any lipid-lowering treatment and less than 40% reached lipid target levels.…”

Section: Do Lipid Abnormalities Predict the Risk For Hypertension?mentioning

confidence: 95%

“…Of these, less than 65% were on any lipid-lowering treatment and less than 40% reached lipid target levels. 25 Genetic studies in humans and animal models suggest that a predisposition for the development of both hypertension and dyslipidaemia may result from the inheritance of shared genetic risk factors. 18,26 In spontaneously hypertensive mice, Bottger et al 26 showed that the genes responsible for BP regulation and those linked to an increased propensity for dyslipidaemia were located in the same three general areas of chromosomes 8, 19 and 20. Among population-based sibships in Utah (USA) with essential hypertension diagnosed before the age of 60 years, the prevalence of familial combined dyslipidaemia was 10 times that of the general population.…”

Section: Do Lipid Abnormalities Predict the Risk For Hypertension?mentioning

confidence: 99%

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Statins: another class of antihypertensive agents?

et al. 2006

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The assessment of global cardiovascular risk is an essential step in the management of atherosclerotic disease prevention. Among the risk factors to be addressed are hypertension and hyperlipidaemia; these commonly coexist. A neutral or lipid-friendly antihypertensive agent is probably useful in the presence of lipid abnormalities. Similarly, statins have been shown to decrease cardiovascular risk in hypertensive patients. There is also experimental and clinical evidence that statins have blood pressure (BP)-lowering effects. In this review, we discuss the beneficial effects of statins on BP, and provide an overview of the underlying pathophysiology. We also consider the evidence justifying the use of statins in the management of hypertensive patients.

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Section: Do Lipid Abnormalities Predict the Risk For Hypertension?mentioning

confidence: 95%

Section: Do Lipid Abnormalities Predict the Risk For Hypertension?mentioning

confidence: 99%

Statins: another class of antihypertensive agents?

et al. 2006

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“…10 Similar data illustrating the low proportion of patients who meet cholesterol goals have been reported in Europe 11 and Japan. 12 The incidence of CHD in the Japanese population is relatively lower than that reported in Western countries, and Japanese patients with CHD do not often have accompanying moderate or marked hypercholesterolemia. [13][14][15] Despite the rapid growth in knowledge of the clinical use of statins obtained from clinical trials, it is still unclear whether a marked reduction of LDL-C in patients with CHD and mild hypercholesterolemia would further reduce the clinical events.…”

mentioning

confidence: 94%

Randomized Evaluation of Atorvastatin in Patients With Coronary Heart Disease A Serial Intravascular Ultrasound Study

Yamada

Azuma

Sasaki

et al. 2007

Circ J

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oronary heart disease (CHD) is the leading cause of death in developed countries, and hypercholesterolemia is an independent risk factor for the progression of atheromatous plaque. Elevated serum cholesterol is causally associated with increased risk of CHD, and a series of randomized trials [1][2][3][4][5][6] have confirmed the benefits of HMG-CoA reductase inhibitors (statins) for hypercholesterolemia in the primary and secondary prevention of CHD. A recent meta-analysis showed that statin therapy reduced the risk of major coronary events by 31% and all-cause mortality by 21%. 7 Guidelines from medical organizations, such as the National Cholesterol Education Program Adult Treatment Panel and the Japan Atherosclerosis Society, suggest that serum low-density lipoproteincholesterol (LDL-C) should be maintained below 100 mg/dl in patients with CHD; 8,9 however, a recent survey, the Lipid Treatment Assessment Project, showed that only approximately 20% of high-risk patients currently achieve Circulation Journal Vol.71, December 2007 these goals. 10 Similar data illustrating the low proportion of patients who meet cholesterol goals have been reported in Europe 11 and Japan. 12 The incidence of CHD in the Japanese population is relatively lower than that reported in Western countries, and Japanese patients with CHD do not often have accompanying moderate or marked hypercholesterolemia. [13][14][15] Despite the rapid growth in knowledge of the clinical use of statins obtained from clinical trials, it is still unclear whether a marked reduction of LDL-C in patients with CHD and mild hypercholesterolemia would further reduce the clinical events. Subgroup analysis from the Cholesterol And Recurrent Event (CARE) trials 16 indicated no additional clinical benefit of treating LDL-C below 125 mg/dl, and the Pravastatin Pooling Project 17 results support this observation. Subgroup analysis from the Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE IT) study 18 showed no additional clinical benefit of intensive lipid-lowering therapy in patients with LDL-C levels below 125 mg/dl. By contrast, the Heart Prevention Study (HPS) indicated a clinical benefit of treating LDL-C from below 116 to below 77 mg/dl. 5 In parallel with clinical outcome trials, some trials using intravascular ultrasound (IVUS) have investigated the effects of statins on the progression of atherosclerosis. [19][20][21] The Reversal study showed a slowing of the progression of atherosclerosis during statin treatment, 20 and the ASTER-OID trial showed regression of coronary atherosclerosis if very low LDL-C levels were achieved. 21 In Japan, however, there have been few studies that show the effects of statin treatment on coronary atherosclerotic lesions. 22 Circ J 2007; 71: 1845 -1850 Background It is unclear whether a marked reduction of low-density lipoprotein-cholesterol (LDL-C) in patients with coronary heart disease (CHD) and mild hypercholesterolemia leads to less progression of atherosclerosis. Methods and ResultsPatients with...

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“…The Eastern Stroke and Coronary Heart Disease Collaborative Research Group (12) reported a strong, continuous association between diastolic blood pressure (DBP) and the risk of both hemorrhagic and non-hemorrhagic stroke in eastern Asian people, including Japanese. Matsubara et al (13) reported that in hypertensives requiring lipid management, the lipid-lowering approach appeared to be insufficient, as the target achievement rate was relatively low, despite the high treatment rate. However, the combined effects of hypertension and hypercholesterolemia on the risk of coronary events and stroke have not been well established in Japan.…”

Section: Introductionmentioning

confidence: 99%

The Risk of Cardiovascular Events in Japanese Hypertensive Patients with Hypercholesterolemia: Sub-Analysis of the Japan Lipid Intervention Trial (J-LIT) Study, a Large-Scale Observational Cohort Study

et al. 2005

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Coronary events and stroke are leading causes of death in Japan. However, the effects of hypertension on the risk of coronary events and stroke have not been well established in Japanese hypercholesterolemic patients. This study aimed to determine the relationship between the risk of coronary events or stroke and blood pressure and cholesterol levels during low-dose simvastatin treatment using data from the Japan Lipid Intervention Trial (J-LIT) study (a large scale nationwide cohort study). In the present study, 47,294 hypercholesterolemic patients were treated with open-labeled simvastatin (5 to 10 mg/day) for 6 years by a large number of physicians in a clinical setting. The adjusted incidence rates of coronary events in males and females were 8.9 and 2.3 and those of stroke were 17.6 and 11.3/1,000 patients during the 6-year period, respectively. The incidence rate of stroke was higher than that of coronary events in both males and females. An obvious sex difference was observed in terms of the incidence of coronary events. The risk of coronary events, stroke, and total cardiovascular events were increased, with elevations in blood pressure observed in patients treated for hypercholesterolemia. The risk of total cardiovascular events in the groups exhibiting less lipid control increased, with lower blood pressure levels than those of the well-controlled group. For patients with hypercholesterolemia and hypertension, blood pressure should be strictly controlled in order to prevent both coronary events and stroke, and the serum total cholesterol levels should be maintained at low levels as well. (Hypertens Res 2005; 28: 879-887)

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Current Status of Lipid Management of Hypertensive Patients

Cited by 13 publications

References 35 publications

Statins: another class of antihypertensive agents?

Statins: another class of antihypertensive agents?

Randomized Evaluation of Atorvastatin in Patients With Coronary Heart Disease A Serial Intravascular Ultrasound Study

The Risk of Cardiovascular Events in Japanese Hypertensive Patients with Hypercholesterolemia: Sub-Analysis of the Japan Lipid Intervention Trial (J-LIT) Study, a Large-Scale Observational Cohort Study

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