Concomitant control of BP, cholesterol is difficult

Many patients suffer from both hypertension and high cholesterol, putting them at greater risk of coronary heart disease (CHD). Controlling the hypertension and high cholesterol would reduce CHD risk by 50% or more, but less than a third of patients have achieved adequate control of both, according to an online study in Circulation.

Using data from 1988 to 2010, researchers found that more than 60% of people with hypertension also had hypercholesterolemia. However, only 30.7% of those with hypertension and high cholesterol had both conditions under control. Overall control slipped to 26.9% when abnormalities of non-high-density lipoprotein cholesterol (HDL-C) were added.

The report indicated that the use of statins and antihypertensive drugs was the only significant predictor of simultaneous control of hypertension, low-density lipoprotein cholesterol (LDL-C), and non-HDL-C. Negative predictors included older age, black race, Hispanic ethnicity, cardiovascular disease, and diabetes.

"More than three-fourths of hypertensive patients were hypercholesterolemic and fewer than 20% controlled in 2005 to 2010, based on lower optional targets," said Brent M. Egan, MD, study coauthor, and, of the Medical University of South Carolina in Charleston. "Significant opportunities remain for attaining national CHD prevention goals by improving concomitant hypertension and hypercholesterolemia control."

The study examined almost 55,000 adults, including 7,080 who were hypertensive and had complete data related to LDL-C and non-HDL-C. The data showed that 4,589 participants were both hypertensive and hyperlipidemic. For study purposes, control of hypertension as blood pressure was defined as <140/90 mm Hg. Hypercholesterolemia was defined by ATP III criteria on the basis 10-year CHD risk, LDL, and non-HDL cholesterol, with values below the diagnostic thresholds defining control.

The Centers for Disease Control and Prevention, the State of South Carolina, and the National Institutes of Health supported the study.