Dyslipidemia and the Risk of Incident Hypertension in Men

Abstract

Abstract-Evidence suggests that hypertension may share a similar pathophysiology with cardiovascular disease (CVD).Thus, dyslipidemia, a strong predictor of CVD, may also predict incident hypertension. We analyzed 3110 men free of hypertension, CVD, and cancer from the Physicians' Health Study, who provided baseline blood samples from which we measured total cholesterol (TC) and HDL cholesterol (HDL-C), and calculated non-HDL-C and the TC/HDL-C ratio. We categorized each lipid parameter into quintiles and considered National Cholesterol Education Project clinical cut points. Other risk factor information was provided from self-reports on the baseline questionnaire. Incident hypertension was defined as either the initiation of antihypertensive treatment, self-reported systolic blood pressure Ն140 mm Hg, or diastolic blood pressure Ն90 mm Hg. Over a mean follow-up of 14.1 years, 1019 men developed hypertension. In Cox proportional hazards models adjusted for lifestyle and clinical risk factors, men in the highest quintile of TC, non-HDL-C, and TC/HDL-C ratio had increased risks of developing hypertension of 23%, 39%, and 54%, respectively, compared with participants in the lowest quintile. Furthermore, men in the highest quintile of HDL-C had a 32% decreased risk of developing hypertension compared with those in the lowest quintile. Models using National Cholesterol Education Project cut points demonstrated similar associations with hypertension. Models excluding men with diabetes and obesity maintained an independent association between baseline lipids and hypertension. These prospective cohort data suggest that dyslipidemias may lead to the subsequent development of hypertension. Thus, plasma lipids may be useful in the identification of men at risk for hypertension. Key Words: cholesterol Ⅲ lipids Ⅲ hypertension Ⅲ blood pressure Ⅲ men Ⅲ prospective studies H ypertension is a common condition that affects Ͼ50 million Americans 1 and is an important risk factor for cardiovascular disease. Although several risk factors for the development of hypertension have been identified, 2 its etiology is still not fully understood. 1 Hypertension is commonly associated with other cardiovascular risk factors, such as obesity, diabetes, and dyslipidemia. 3 The presence of these cardiovascular risk factors and the resulting endothelial dysfunction may play a role in the pathophysiology of hypertension. 4 Dyslipidemia, a strong predictor of cardiovascular disease, 5 causes endothelial damage, 6 -8 and the loss of physiological vasomotor activity that results from endothelial damage may become manifested as increased blood pressure (BP). Therefore, factors like dyslipidemia that cause endothelial dysfunction may lead to hypertension. Cross-sectional studies have suggested a link between abnormal lipids and hypertension. 4,9,10 A few studies have prospectively examined the relationship between plasma lipids and the future development of hypertension, finding that there is an association between plasma lipids and development of hyp...

Dysglycaemia in non-diabetic hypertensive patients: comparison of the impact of two different classifications of impaired fasting glucose on the cardiovascular risk profile

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Redox Control of Renal Function and Hypertension

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Treatment patterns of hypertension and dyslipidaemia in hypertensive patients at higher and lower risk of cardiovascular disease in primary care in the United Kingdom

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