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Serum cholesterol affects blood pressure regulation
L A Ferrara1, L Guida, R Iannuzzi
1Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. ferrara@unina.it
Insights
High serum cholesterol levels in patients with newly discovered hypertension are linked to increased blood pressure response during sympathetic stimulation. This suggests cholesterol impacts hypertensive complications and target organ damage.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Syndrome
Background:
- Epidemiological studies indicate a link between lipid metabolism abnormalities and arterial hypertension.
- Understanding the independent effect of serum cholesterol on blood pressure is crucial for managing hypertensive complications.
Purpose of the Study:
- To investigate if serum cholesterol affects resting, ambulatory, or sympathetic-stimulated blood pressure independently of body weight and insulin.
- To assess the influence of cholesterol on hypertensive complications and target organ disease.
Main Methods:
- Seventy-three newly diagnosed, treatment-naive hypertensive patients were stratified into tertiles based on serum cholesterol.
- Blood pressure was measured at rest, during 24-hour monitoring, and during isometric handgrip exercise.
- Cardiac mass and carotid intima-media thickness were assessed using echocardiography.
Main Results:
- Groups were comparable in body weight, blood glucose, and serum insulin, but differed in cholesterol and triglyceride levels.
- Blood pressure at rest and during 24-hour monitoring showed no significant differences between groups.
- A significant increase in systolic and diastolic blood pressure during handgrip (sympathetic stimulation) was observed in higher cholesterol tertiles (P < 0.01).
- Carotid intima-media thickness was significantly greater in patients with higher cholesterol levels (P < 0.05).
Conclusions:
- Serum cholesterol levels influence blood pressure response to adrenergic stimulation in hypertensive patients.
- Elevated cholesterol may contribute to target organ damage, such as carotid artery wall thickening, in early hypertension.
- Cholesterol management is important for mitigating cardiovascular risk in patients with newly diagnosed hypertension.
Abstract:
A close relationship between abnormalities of the lipid metabolism and arterial hypertension has been observed in several epidemiological studies. The aim of the present study was to investigate whether serum cholesterol might affect blood pressure (BP) levels at rest, during ambulatory monitoring or during sympathetic stimulation-independently of other variables such as body weight or serum insulin-thus influencing the outcome of hypertensive complications. Seventy-three patients with sustained newly-discovered and never-treated hypertension were divided into tertiles according to their serum cholesterol levels and their resting BP, 24-h BP and BP during isometric exercise (handgrip) were compared. Cardiac mass and carotid wall thickness were measured by echographic technique. The results were that tertiles were similar for body weight, blood glucose and serum insulin, but different for serum cholesterol and triglycerides. BP at rest and during 24-h monitoring was similar in the three groups, whilst a significant difference was detected during sympathetic stimulation by handgrip, with systolic and diastolic BP increasing by 16/12, 28/19 and 30/23 mm Hg (P < 0.01) in lower, medium and higher tertiles, respectively. Intima-media layer of the carotid arteries was also significantly thickened in the groups with higher cholesterol levels (0.54 +/- 0.07, 0.67 +/- 0.14, 0.68 +/- 0.15, P < 0.05). These data support the conclusion that even in patients with recently discovered hypertension, cholesterol levels may influence the BP response to adrenergic stimulation as well as the outcome of target organ disease.