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Synergistic actions of hypertension and dyslipidemia on endothelial function

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

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  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

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