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Hypertension, Cholesterol Often Twin Threats

Many patients aren't being treated for high cholesterol problems

MONDAY, June 28, 2004 (HealthDayNews) -- Many people with high blood pressure are likely to have high blood cholesterol levels that aren't being treated properly, a new study reports.

Both high blood pressure (hypertension) and high cholesterol are significant risk factors for cardiovascular problems such as heart attack or stroke. The study, by researchers at the Mayo Clinic, found that "this double whammy has enormous implications for disease prevention," said Dr. Stephen Turner, a Mayo nephrologist and hypertension specialist who was the lead author of the report. It appears in the June 28 issue of the Archives of Internal Medicine.

The study participants consisted of approximately 1,000 white residents from the Mayo Clinic's hometown of Rochester, Minn., and nearly 1,300 black residents of Jackson, Miss. All had high blood pressure.

Roughly half of the black participants -- 49.5 of the women and 56.7 percent of the men -- also had hyperlipidemia, the medical name for unhealthy levels of cholesterol. The same was true for an even larger percentage of the white participants -- 78.4 percent of the men and 64.7 percent of the women.

Yet fewer than one-third of those with high cholesterol levels were taking cholesterol-lowering drugs such as statins. And fewer than half of those taking the drugs had reached recommended levels of cholesterol, the study found.

"The concordance of hypertension and high lipids (cholesterol levels) is not new," said Cashell Jaquist, a genetic epidemiologist at the National Heart, Lung, and Blood Institute. "We have seen it in some other studies. What is surprising is the lack of treatment for the lipid problems."

The finding has implications for medical genetics, Jaquist added. "We haven't looked for some forms of hypertension as a common genetic disorder that might also affect lipids. This is a hypothesis that this study has raised, something to look at in the future."

Turner said the finding surprised him because participants in the study were chosen because they had high blood pressure and thus were expected to be aware of other cardiovascular risk factors, such as cholesterol levels. They were well aware of the risks of high blood pressure, Turner said.

"But the rates of people being treated and controlled for high lipid levels were comparable to those seen in other groups," he said.

The study was not designed to determine the reasons for undertreatment of cholesterol levels, but Turner said he could speculate "on the basis of my own clinical practice."

"High blood cholesterol is one of a number of asymptomatic (symptomless) problems that people can have," he said. "It is generally recognized that many people, both physicians and patients, are reluctant to use medications for problems that are asymptomatic."

But the need for people with high blood pressure to keep their cholesterol levels down is urgent, Turner said. "There is a synergistic risk," he said. "The whole is greater than the sum of the parts."

More information

The National Heart, Lung, and Blood Institute has details on the DASH diet, which is designed to combat high blood pressure but is also effective against high cholesterol.

SOURCES: Stephen Turner, M.D., nephrologist, Mayo Clinic, Rochester, Minn.; Cashell Jaquist, genetic epidemiologist, National Heart, Lung, and Blood Institute, Bethesda, Md.: June 28, 2004, Archives of Internal Medicine
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