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The Tromsø Heart Study: coronary risk factor levels in treated and untreated hypertensives
1Institute of Community Medicine, University of Tromsø, Norway.
Insights
Hypertension is linked to higher cholesterol, but antihypertensive drugs may decrease HDL cholesterol and increase triglycerides. Careful risk factor management is crucial for reducing coronary heart disease mortality.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Hypertension is a significant risk factor for coronary heart disease (CHD).
- Understanding the interplay of coronary risk factors in hypertensive individuals is essential for effective treatment strategies.
Purpose of the Study:
- To analyze and compare coronary risk factors, including cholesterol, HDL cholesterol, and triglycerides, in medically treated hypertensives, untreated hypertensives, and normotensives.
- To investigate the potential impact of antihypertensive drug treatment on these lipid profiles.
Main Methods:
- Cross-sectional study involving 288 medically treated hypertensives, 1293 untreated hypertensives, and 15,029 normotensives.
- Comparative analysis of lipid profiles (cholesterol, HDL cholesterol, triglycerides) across the three groups.
Main Results:
- Untreated hypertensives exhibited higher cholesterol levels compared to normotensives (p < 0.001).
- Medically treated hypertensives showed lower HDL cholesterol (p < 0.01) and higher triglycerides (p < 0.01) compared to untreated hypertensives.
- Elevated triglycerides were also observed in normotensives compared to untreated individuals (p < 0.01).
Conclusions:
- The observed increase in cholesterol in hypertensives appears to be an original characteristic, whereas decreased HDL cholesterol and elevated triglycerides may be drug-induced.
- Antihypertensive drug treatment necessitates a comprehensive consideration of the entire risk factor constellation to effectively reduce CHD mortality.
Abstract:
Coronary risk factors are described in 288 medically treated hypertensives, 1293 untreated hypertensives and 15,029 normotensives. Cholesterol in untreated men and women was 0.37 mmol/l and 0.35 mmol/l higher than in normotensives (p less than 0.001). Non-significant differences were observed between those untreated and treated. Treated men and women had 0.16 mmol/l and 0.14 mmol/l lower HDL cholesterol than untreated (p less than 0.01). Between untreated and normotensives non-significant differences were found. Triglycerides were 0.27 mmol/l and 0.22 mmol/l higher in treated than in untreated men and women (p less than 0.01). Normotensive men and women had 0.33 mmol/l and 0.10 mmol/l lower triglycerides than untreated (p less than 0.01). The results suggest that the increased cholesterol in hypertensives was present originally, while the decreased HDL cholesterol and elevated triglycerides probably were evoked by drugs. The importance of consideration of the whole constellation of risk factors in order to reduce the mortality from coronary heart disease by antihypertensive drug treatment is emphasized.