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Dyslipidemic hypertension: distinctive features and cardiovascular risk in a prospective population-based study.
Am J Hypertens 2005; 18(3):409-16AJ

Abstract

BACKGROUND

The prevalence, features, and risk of cardiovascular disease (CVD) in dyslipidemic hypertension (DH) was investigated in a prospective population-based study. Dyslipidemic hypertension was defined in terms of blood pressure, plasma triglycerides, and HDL-cholesterol consistent with the metabolic syndrome criteria of the National Cholesterol Education Program guidelines. High-normal or hypertensive values not meeting the other two criteria were designated as "simple hypertensives" (SH).

METHODS

A sample of 2225 men and women and free of CVD at baseline were followed up for a mean of 4.1 years. The proportions of DH, SH, and normotensives were 16%, 37%, and 47%, respectively. All persons with DH had metabolic syndrome by definition, whereas metabolic syndrome formed 44.6% of SH. Fatal and nonfatal CVD, diagnosed by clinical findings and Minnesota coding of resting electrocardiograms, developed in 166 subjects.

RESULTS

Compared to SH, sex- and age-standardized individuals with DH had significantly higher body mass index, apolipoprotein B, fasting insulin, glucose, and C-reactive protein levels, had higher prevalence of impaired fasting glucose and metabolic syndrome. Cox regression analysis revealed a 1.57-fold higher (confidence interval 1.08-2.28) hazard ratio (HR) for CVD in DH than in SH, after adjustment for sex, age, LDL-cholesterol, and smoking status. The sex- and age-adjusted HR of DH was furthermore 1.45-fold higher than the remaining subjects with metabolic syndrome (P = .096). Among persons with DH, age, presence of diabetes, and pulse pressure proved to be independent predictors for CVD. High LDL-cholesterol levels and fasting hyperinsulinemia were associated with borderline significantly elevated relative risks among dyslipidemic hypertensives.

CONCLUSIONS

Dyslipidemic hypertension, prevailing in 1 of every 6 adults, implicates characteristic features, confers excess CVD risk compared to the remainder of hypertensives and carries half the attributable cardiovascular risk due to metabolic syndrome.

Authors+Show Affiliations

Turkish Society of Cardiology, Biology Department, Nisbetiye cad. 37/24 Etiler, 80630 Istanbul, Turkey. tkd@tkd.org.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15797662

Citation

Onat, Altan, et al. "Dyslipidemic Hypertension: Distinctive Features and Cardiovascular Risk in a Prospective Population-based Study." American Journal of Hypertension, vol. 18, no. 3, 2005, pp. 409-16.
Onat A, Hergenç G, Sari I, et al. Dyslipidemic hypertension: distinctive features and cardiovascular risk in a prospective population-based study. Am J Hypertens. 2005;18(3):409-16.
Onat, A., Hergenç, G., Sari, I., Türkmen, S., Can, G., & Sansoy, V. (2005). Dyslipidemic hypertension: distinctive features and cardiovascular risk in a prospective population-based study. American Journal of Hypertension, 18(3), pp. 409-16.
Onat A, et al. Dyslipidemic Hypertension: Distinctive Features and Cardiovascular Risk in a Prospective Population-based Study. Am J Hypertens. 2005;18(3):409-16. PubMed PMID: 15797662.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dyslipidemic hypertension: distinctive features and cardiovascular risk in a prospective population-based study. AU - Onat,Altan, AU - Hergenç,Gülay, AU - Sari,Ibrahim, AU - Türkmen,Serdar, AU - Can,Günay, AU - Sansoy,Vedat, PY - 2004/08/03/received PY - 2004/10/05/revised PY - 2004/10/09/accepted PY - 2005/3/31/pubmed PY - 2005/6/29/medline PY - 2005/3/31/entrez SP - 409 EP - 16 JF - American journal of hypertension JO - Am. J. Hypertens. VL - 18 IS - 3 N2 - BACKGROUND: The prevalence, features, and risk of cardiovascular disease (CVD) in dyslipidemic hypertension (DH) was investigated in a prospective population-based study. Dyslipidemic hypertension was defined in terms of blood pressure, plasma triglycerides, and HDL-cholesterol consistent with the metabolic syndrome criteria of the National Cholesterol Education Program guidelines. High-normal or hypertensive values not meeting the other two criteria were designated as "simple hypertensives" (SH). METHODS: A sample of 2225 men and women and free of CVD at baseline were followed up for a mean of 4.1 years. The proportions of DH, SH, and normotensives were 16%, 37%, and 47%, respectively. All persons with DH had metabolic syndrome by definition, whereas metabolic syndrome formed 44.6% of SH. Fatal and nonfatal CVD, diagnosed by clinical findings and Minnesota coding of resting electrocardiograms, developed in 166 subjects. RESULTS: Compared to SH, sex- and age-standardized individuals with DH had significantly higher body mass index, apolipoprotein B, fasting insulin, glucose, and C-reactive protein levels, had higher prevalence of impaired fasting glucose and metabolic syndrome. Cox regression analysis revealed a 1.57-fold higher (confidence interval 1.08-2.28) hazard ratio (HR) for CVD in DH than in SH, after adjustment for sex, age, LDL-cholesterol, and smoking status. The sex- and age-adjusted HR of DH was furthermore 1.45-fold higher than the remaining subjects with metabolic syndrome (P = .096). Among persons with DH, age, presence of diabetes, and pulse pressure proved to be independent predictors for CVD. High LDL-cholesterol levels and fasting hyperinsulinemia were associated with borderline significantly elevated relative risks among dyslipidemic hypertensives. CONCLUSIONS: Dyslipidemic hypertension, prevailing in 1 of every 6 adults, implicates characteristic features, confers excess CVD risk compared to the remainder of hypertensives and carries half the attributable cardiovascular risk due to metabolic syndrome. SN - 0895-7061 UR - https://www.unboundmedicine.com/medline/citation/15797662/Dyslipidemic_hypertension:_distinctive_features_and_cardiovascular_risk_in_a_prospective_population_based_study_ L2 - https://academic.oup.com/ajh/article-lookup/doi/10.1016/j.amjhyper.2004.10.017 DB - PRIME DP - Unbound Medicine ER -