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Synergistic actions of hypertension and dyslipidemia on endothelial function. Implications for treatment. Dyslipidemia. Statins. Synergistic loss in endothelial function. Synergistic increase in endothelial function. Hypertension. Antihypertensives.
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Synergistic actions of hypertension and dyslipidemia on endothelial function Implications for treatment Dyslipidemia Statins Synergistic loss in endothelialfunction Synergistic increase in endothelialfunction Hypertension Antihypertensives Mason RP et al. Circulation. 2004;109(suppl II):II-34-41. Mason RP et al. ATVB. 2003;23:2155-63.
High prevalence of multiple CV risk factorsin hypertensive adults Behavioral Risk Factor Surveillance System, 1999 80 73 US adults≥18 yrs with additional risk factors (%) 60 42 40 35 22 20 12 0 High cholesterollevel Diabetes Obesity Smoking ≥1 otherCV riskfactors Percentages are weighted to state population estimates and age adjusted to the 2000 US standard population using 4 age groups Greenlund KJ et al. Arch Intern Med. 2004;164:181-8.
20–44 45–54 55–64 ≥65 20–44 45–54 55–64 ≥65 Prevalence of hypertension and dyslipidemiaincreases with age Kaiser Permanente Medical Care Program, Northern California, 2001 Hypertension Dyslipidemia Both 70 70 Men Women 60 60 50 50 Prevalence(%) 40 40 30 30 20 20 10 10 0 0 Age (yrs) Age (yrs) Selby JV et al. Am J Manag Care. 2004;10(2 part 2):163-70.
Dyslipidemia in hypertensive adults: High prevalence, insufficient treatment Genetic Epidemiology Network of Arteriopathy (GENOA) study 100 Prevalence Treatment Control 80 60 Hypertensivesubjects(%) 78.4 64.7 40 49.5 56.7 20 25.5 16.4 8.1 8.6 7.3 5.8 4.1 3.8 0 Women Men Women Men African American(n = 1286) White(n = 1070) O’Meara JG et al. Arch Intern Med. 2004;164:1313-8.
Number of antihypertensive agents neededto achieve systolic BP control SBP achieved(mm Hg) Trial ALLHAT 138 IDNT 138 RENAAL 141 UKPDS 144 ABCD 132 MDRD 132 HOT 138 AASK 128 * INVEST 131 Number of BP medications† 1 2 3 4 *~50% patients required ≥3 †Average per patient Bakris et al. Am J Kidney Dis. 2000;36:646-61. ALLHAT. JAMA. 2002;288:2981-97. Berl et al. Ann Intern Med. 2003;138:542-9. Bakris et al. Arch Inten Med. 2003;163:1555-65. Wright et al. JAMA. 2002;288:2421-31. Pepine et al. JAMA. 2003;2980:2805-16.
Gemini: LDL-C and BP goal achievementby multiple-risk patients 90 82.1 80 65.5 70 57.7 60 Patientsat goal(%) 50 40 30 20 10 0 LDL-C goal(NCEP ATP III) BP goal(JNC VI) Both LDL-Cand BP goals NCEP ATP III. JAMA. 2001;285:2486-97. JNC VI. Arch Int Med. 1997;157:2413-46. Blank R et al. J Am Coll Cardiol. 2004;43(suppl A):447A. N = 1220