"This points out both a serious problem and a significant opportunity to prevent disease of the heart and blood vessels," says Stephen Turner, M.D., the Mayo Clinic hypertension specialist who led the study. "Nearly 50 million U.S. adults have hypertension. Our study suggests that more than two-thirds of them also have high cholesterol that likely is not being treated aggressively enough. This double whammy has enormous implications for disease prevention."
The findings come from the Genetic Epidemiology Network of Arteriopathy (GENOA) study. Investigators studied two hypertensive populations: 1,070 non-Hispanic whites from Rochester, Minn., and 1,286 non-Hispanic blacks from Jackson, Miss. About one-half of the blacks with high blood pressure (49.5 percent of women and 56.7 percent of men) also had high cholesterol (hyperlipidemia). More than three-fourths (78.4 percent) of the white male hypertensives - and 64.7 percent of the women - had hyperlipidemia. Among study subjects with both risk factors, fewer than one out of three were taking cholesterol-lowering medications (primarily statins), and less than one-half of those had reached recommended lipid levels. Whites were more likely than blacks and white men were more likely than white women to be taking lipid-lowering medications, but this did not translate into statistically better control of cholesterol problems.
Dr. Turner says patients who have hypertension should have their cholesterol checked, and should treat both problems aggressively. "High blood pressure and high cholesterol are two of the most important risk factors for heart attack and stroke," says Dr. Turner. "Having both doesn't just add to your risk of cardiovascular disease - it multiplies the risk. And if you have high blood pressure, our study suggests you are likely to have lipid abnormalities.
"But unlike sex or family history, these risk factors can be modified. Because nine out of ten people who have both hypertension and dyslipidemia are now receiving either no treatment or inadequate treatment for their cholesterol problems, we can significantly improve the health outlook for these individuals and for our society by simply applying the therapies we already have," Dr. Turner concludes.
Co-authors of the paper, "Ethnic and Sex Differences in the Prevalence, Treatment, and Control of Dyslipidemia Among Hypertensive Adults in the GENOA Study," include John O'Meara, Pharm.D., Jeffrey Armon, Pharm.D., and Dr. Turner from Mayo Clinic; Sharon Kardia, Ph.D., from the University of Michigan, Ann Arbor; C. Andrew Brown, M.D., from the University of Mississippi, Jackson; and Eric Boerwinkle, Ph.D., from the University of Texas Health Science Center at Houston.
Journal
Archives of Internal Medicine