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VBWG Synergistic actions of hypertension and dyslipidemia on endothelial function Implications for treatment Mason RP et al. Circulation. 2004;109(suppl.

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Presentation on theme: "VBWG Synergistic actions of hypertension and dyslipidemia on endothelial function Implications for treatment Mason RP et al. Circulation. 2004;109(suppl."— Presentation transcript:

1 VBWG Synergistic actions of hypertension and dyslipidemia on endothelial function Implications for treatment Mason RP et al. Circulation. 2004;109(suppl II):II Mason RP et al. ATVB. 2003;23: Statins Antihypertensives Dyslipidemia Hypertension Synergistic loss in endothelial function Synergistic increase in endothelial function

2 VBWG High prevalence of multiple CV risk factors in hypertensive adults 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: High cholesterol level DiabetesObesitySmoking≥1 other CV risk factors US adults ≥18 yrs with additional risk factors (%) Behavioral Risk Factor Surveillance System, 1999

3 VBWG Prevalence of hypertension and dyslipidemia increases with age Kaiser Permanente Medical Care Program, Northern California, 2001 Selby JV et al. Am J Manag Care. 2004;10(2 part 2): Prevalence (%) HypertensionDyslipidemiaBoth Women Men 20–44 55–64 ≥ –44 45–54 55–64 ≥65 45–54 Age (yrs)

4 VBWG Dyslipidemia in hypertensive adults: High prevalence, insufficient treatment Genetic Epidemiology Network of Arteriopathy (GENOA) study O’Meara JG et al. Arch Intern Med. 2004;164: WomenMen African American (n = 1286) PrevalenceTreatmentControl WomenMen White (n = 1070) 25.5 Hypertensive subjects (%)

5 VBWG Number of antihypertensive agents needed to achieve systolic BP control Bakris et al. Am J Kidney Dis. 2000;36: ALLHAT. JAMA. 2002;288: Berl et al. Ann Intern Med. 2003;138: Bakris et al. Arch Inten Med. 2003;163: Wright et al. JAMA. 2002;288: Pepine et al. JAMA. 2003;2980: *~50% patients required ≥3 † Average per patient 4321 Number of BP medications † Trial SBP achieved (mm Hg) ALLHAT138 IDNT138 RENAAL141 UKPDS144 ABCD132 MDRD132 HOT138 AASK128 INVEST131 *

6 VBWG Gemini: LDL-C and BP goal achievement by multiple-risk patients NCEP ATP III. JAMA. 2001;285: JNC VI. Arch Int Med. 1997;157: Blank R et al. J Am Coll Cardiol. 2004;43(suppl A):447A LDL-C goal (NCEP ATP III) BP goal (JNC VI) Both LDL-C and BP goals Patients at goal (%) N = 1220


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