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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-34-41. Mason RP et al. ATVB. 2003;23:2155-63. 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;164:181-8. 0 20 40 60 80 High cholesterol level DiabetesObesitySmoking≥1 other CV risk factors US adults ≥18 yrs with additional risk factors (%) 42 12 35 22 73 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):163-70. 60 70 0 10 20 30 40 50 Prevalence (%) HypertensionDyslipidemiaBoth Women Men 20–44 55–64 ≥65 60 70 0 10 20 30 40 50 20–44 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;164:1313-8. 80 100 60 40 20 0 WomenMen 49.5 8.1 4.1 56.7 7.3 3.8 African American (n = 1286) PrevalenceTreatmentControl WomenMen 64.7 16.4 5.8 78.4 8.6 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;36:646-61. 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. *~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;285:2486-97. JNC VI. Arch Int Med. 1997;157:2413-46. Blank R et al. J Am Coll Cardiol. 2004;43(suppl A):447A. 0 10 20 30 40 50 60 70 80 90 LDL-C goal (NCEP ATP III) BP goal (JNC VI) Both LDL-C and BP goals Patients at goal (%) 82.1 65.5 57.7 N = 1220


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