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Hypertension, changes in high-density lipoproteins and antihypertensive therapy

W Flamenbaum1

  • 1Beth Israel Medical Center, New York, New York 10009.

The American Journal of Cardiology
|June 5, 1989
PubMed

Insights

Hypertension treatment can reduce some health issues but not always coronary heart disease (CHD). Some blood pressure drugs may worsen lipid levels, impacting CHD risk. Choosing the right medication is key for managing both hypertension and cholesterol.

Area of Science:

  • Cardiology
  • Pharmacology
  • Preventive Medicine

Background:

  • Coronary heart disease (CHD) risk is linked to hypertension and lipid abnormalities.
  • High-density lipoprotein (HDL) cholesterol shows an inverse relationship with CHD.
  • Antihypertensive pharmacologic treatment reduces some hypertension sequelae but not consistently CHD.

Purpose of the Study:

  • To explore the dissociation between blood pressure reduction and CHD reduction.
  • To investigate the role of antihypertensive agents in altering blood lipid levels.
  • To determine if antihypertensive agents can be classified as atherogenic or antiatherogenic.

Main Methods:

  • Review of existing observational and short-term studies on hypertension, lipids, and CHD.
  • Analysis of potential mechanisms by which antihypertensive agents affect lipid profiles.
  • Conceptual framework for subclassifying antihypertensive drugs based on lipid effects.

Main Results:

  • Pharmacologic hypertension treatment effectively reduces risks like renal failure and stroke.
  • A consistent reduction in associated CHD has not been demonstrated with all antihypertensive therapies.
  • Alterations in HDL cholesterol and other lipids induced by antihypertensive agents may counteract blood pressure benefits.

Conclusions:

  • The choice of antihypertensive agents may influence CHD risk through effects on lipid profiles.
  • Antihypertensive drugs could be classified by their atherogenic or antiatherogenic potential.
  • Selecting agents that manage hypertension without negatively impacting lipid profiles is crucial for patients with dyslipidemia.

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