Can high blood pressure lead to high cholesterol

Introduction

High blood pressure and cholesterol levels are the key risk factors for heart disease. Patients with hypertension exhibit elevated total cholesterol, low-density lipoprotein, and reduced high-density cholesterol levels. On the contrary, high cholesterol levels may lead to hypertension. Hypertension and high cholesterol frequently coexist and are known as dyslipidemic hypertension. Dyslipidemic hypertension is also referred to currently as lipitension.

Statistics

The prevalence of high cholesterol is high (50% to 75%) in hypertensive patients.

Etiopathogenesis

Several mechanisms explain the association between high cholesterol and hypertension. By altering vasomotor mechanisms mediated by nitric oxide, high cholesterol alters endothelial function causing increase in blood pressure. Renal microvascular injuries due to high cholesterol also contribute to hypertension. Limited data demonstrates the effect of elevated blood pressure on lipid levels.

Clinical features

Dyslipidemic hypertension often causes no signs and symptoms but is a significant risk factor for atherosclerosis in coronary artery patients.

Complications

Cardiovascular disease includes coronary heart disease, stroke and peripheral arterial disease. Lipitension is the crucial risk factor for the occurrence of these cardiovascular events.

Investigations

The following tests diagnose individuals with high blood pressure and cholesterol levels. This includes
  • High blood pressure
  • Adverse lipid profile (high LDL cholesterol, low HDL cholesterol)
  • Elevated Body mass index (25 to 29.9)
  • High levels of C reactive protein (>1.0 mg/dl)

Treatment

Because hypertension and high cholesterol levels frequently coexist treatment approach should be aimed at improving both high blood pressure and lipid levels.

This includes drug therapy, i.e. statins (Atorvastatin, Lovastatin, Pravastatin, Simvastatin, rosuvastatin) along with antihypertensive agents (captopril, enalapril, amlodipine, nifedipine, verapamil). Statins lower the high LDL cholesterol (bad) while antihypertensive lower blood pressure in these patients.

ACE – inhibitors, when combined with calcium channel blockers, offers prevention against heart diseases in these individuals. The list of the commonly prescribed ACE inhibitors and calcium channel blockers is mentioned below.

  • ACE inhibitors (captopril, enalapril, Lisinopril, perindopril, quinapril)
  • Calcium channel blockers (amlodipine, diltiazem, Felodipine, nicardipine, nifedipine, verapamil)

Prevention

Lowering cholesterol levels in hypertensive individuals reduces the risk of coronary diseases.

Dietary approaches to lower cholesterol levels

  • Reduce intake of dietary fats, particularly saturated fats
  • Foods such as margarine reduce LDL cholesterol by about 10%
  • Increasing intake of fiber in the form of cereal grains, fruits, and vegetables
  • Quit all kinds of tobacco (smoking and chewing)

Physical activity

Maintaining bodyweight in the desirable range by engaging in moderate physical activity helps complements these dietary strategies

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