Patterns of lipid profile abnormalities in hypertensive patients and normotensive subjects: a cross-sectional observational study
Keywords:Cardiovascular, Dyslipidaemia, Hypertension, Lipid profile, Total cholesterol, Triglyceride
Background: It is a well-known fact that hypertension and altered lipid profile or dyslipidaemia are leading risk factors for cardiovascular diseases. The coexistence of these two conditions has remained an interesting matter, among cardiologists and researchers alike. In this study, we analysed the serum lipid patterns of hypertensive patients and normotensive control subjects.
Methods: This cross-sectional observational study was conducted in a tertiary healthcare and teaching center of Northwestern India during the period of 2010 and 2011. The study comprised of 100 hypertensive patients and 100 normotensive control subjects. Data were collected regarding demographic details, past medical/drug history and lipid profile including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL).
Results: A total of 200 subjects with the age above 20 years were enrolled in the study. The mean BMI in hypertensive patients (24.14±2.15 kg/m2) was significantly higher than normotensive subjects (22.60±2.62 kg/m2) (p<0.05). When we compared the mean of TC and TG among the hypertensive patients and normotensive subjects, highly significant differences were obtained (p<0.001). The significant decline in mean HDL level was observed in hypertensive patients than normotensive subjects (40.41±4.57 versus 44.64±5.97, p<0.005).
Conclusions: The dyslipidaemia has been more evident among hypertensive patients. Hence, the measurement of blood pressure and lipid profile are of great importance to prevent cardiovascular diseases, stroke and other comorbidities.
Kannel WB, Castelli WP, Gordon T, McNamara PM. Serum cholesterol, lipoproteins, and the risk of coronary heart disease. The Framingham study. Ann Intern Med. 1971;74(1):1-12.
Williams RR, Hunt SC, Hopkins PN, Stults BM, Wu LL, Hasstedt SJ, et al. Familial dyslipidemic hypertension. Evidence from 58 Utah families for a syndrome present in approximately 12% of patients with essential hypertension. JAMA. 1988;259(24):3579-86.
Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-97.
Johnson ML, Pietz K, Battleman DS, Beyth RJ. Prevalence of comorbid hypertension and dyslipidemia and associated cardiovascular disease. Am J Manag Care. 2004;10(12):926-32.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The seventh report of the joint National committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560-72.
Borghi C. Interactions between hypercholesterolemia and hypertension: implications for therapy. Curr Opin Nephrol Hypertens. 2002;11(5):489-96.
Edozien J. Establishment of a biochemical norm for the evaluation of nutrition status in West Africa. J West Afr Sci Assoc. 1965;10:3-21.
Onitiri AC, Sander M, Boyo AE. Serum lipids and lipoproteins in healthy Africans. Clin Chim Acta. 1977;81(1):57-61.
Knuiman JT, West CE. HDL cholesterol in men from thirteen countries: Lancet. 1981;2(8242):367-8.
Otsuka T, Takada H, Nishiyama Y, Kodani E, Saiki Y, Kato K, et al. Dyslipidemia and the Risk of Developing Hypertension in a Working-Age Male Population. J Am Heart Assoc. 2016;5(3):003053.
Anand SS, Hawkes C, deSouza RJ, Mente A, Dehghan M, Nugent R, et al. Food consumption and its impact on cardiovascular disease: importance of solutions focused on the globalized food system: a report from the workshop convened by the World heart federation. J Am Coll Cardiol. 2015;66(14):1590-614.
Pemminati S, Adhikari MR, Pathak R, Pai MR. Prevalence of metabolic syndrome (METS) using IDF 2005 guidelines in a semi urban south Indian (Boloor Diabetes Study) population of Mangalore. J Assoc Physicians India. 2010;58:674-7.
Mohan V, Deepa R, Rani SS, Premalatha G. Prevalence of coronary artery disease and its relationship to lipids in a selected population in South India: the Chennai urban population study (CUPS No. 5). J Am Coll Cardiol. 2001;38(3):682-7.
Mohan V, Sandeep S, Deepa M, Gokulakrishnan K, Datta M, Deepa R. A diabetes risk score helps identify metabolic syndrome and cardiovascular risk in Indians-the Chennai Urban Rural Epidemiology Study (CURES-38). Diabetes Obes Metab. 2007;9(3):337-43.
Pelkonen R, Nikkilä EA, Koskinen S, Penttinen K, Sarna S. Association of serum lipids and obesity with cardiovascular mortality. Br Med J. 1977;2(6096):1185-7.
Akpa MR, Agomouh DI, Alasia DD. Lipid profile of healthy adult Nigerians in Port Harcourt, Nigeria. Niger J Med. 2006;15(2):137-40.
Salgar VB, Mehvish M. Lipid profile and C-reactive protein in male normotensive and hypertensive individuals-a comparative study. Int J Contemp Med Res. 2018;6:118.
Osuji CU, Omejua EG, Onwubuya EI, Ahaneku GI. Serum lipid profile of newly diagnosed hypertensive patients in Nnewi, South-East Nigeria. Int J Hypertens. 2012;710486(10):4.
Choudhury K, Mainuddin A, Wahiduzzaman M, Islam SM. Serum lipid profile and its association with hypertension in Bangladesh. Vasc Health Risk Manag. 2014;10:327-32.
Albucher JF, Ferrieres J, Ruidavets JB, Guiraud-Chaumeil B, Perret BP, Chollet F. Serum lipids in young patients with ischaemic stroke: a case-control study. J Neurol Neurosurg Psychiatry. 2000;69(1):29-33.
McGill HC. Introduction to the geographic pathology of atherosclerosis. Lab Invest. 1968;18(5):465-7.
Kesteloot H, Lee CS, Park HM, Kegels C, Geboers J, Claes JH, et al. A comparative study of serum lipids between Belgium and Korea. Circulation. 1982;65(4):795-9.
Jagla A, Schrezenmeir J. Postprandial triglycerides and endothelial function. Exp Clin Endocrinol Diabetes. 2001;109(04):533-47.
Yao W, Zhang H, Zhu Z, Zhou Y, Liang N, Xu D, et al. Genetically elevated levels of circulating triglycerides and brachial–ankle pulse wave velocity in a Chinese population. J Hum Hypertens. 2013;27(4):265-70.
Lundman P, Eriksson M, Schenck-Gustafsson K, Karpe F, Tornvall P. Transient triglyceridemia decreases vascular reactivity in young, healthy men without risk factors for coronary heart disease. Circulation. 1997;96(10):3266-8.
Kwiterovich PO. The antiatherogenic role of high-density lipoprotein cholesterol. Am J Cardiol. 1998;82(8):13-21.
Dasti M, Fasih S, Zulfiquar S, Nawaz H, Karim I, Baloch Z. Dyslipidemia in patients with essential hypertension. Res Net. 2017;2017:511-5.
Rao S, Subash YE. The effect of chronic tobacco smoking and chewing on the lipid profile. JCDR Res. 2013;7(1):31-4.