Combined association of lipids and blood pressure in relation to incident cardiovascular disease in the elderly: The cardiovascular health study

Nathan D. Wong, Victor A. Lopez, Craig S. Roberts, Henry A. Solomon, Gregory L. Burke, Lewis Kuller, Russell Tracy, Norbert Yanez, Bruce M. Psaty

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Hypertension and dyslipidemia are highly prevalent in the elderly. We studied the combined impact of both conditions on cardiovascular disease (CVD) events.MethodsWe studied 4,311 participants aged 65-98 (61.2% female) from the Cardiovascular Health Study (CHS), a longitudinal epidemiologic study, with no prior CVD. We evaluated the relation of low-density lipoprotein (LDL), high-density lipoprotein (HDL), or non-HDL-cholesterol combined with blood pressure (BP) categories to incident CVDincluding coronary heart disease (CHD) (angina, myocardial infarction (MI), angioplasty, coronary bypass surgery, or CHD death), stroke, claudication, and CVD death over 15 years.ResultsCVD incidence (per 1,000 person years) ranged from 38.4 when BP <120/80mmHg and LDL-C <100mg/dl to 94.8 when BP ≥160/100mmHg and LDL-C ≥160mg/dl, and from 28.9 when BP <120/80mmHg and HDL >60mg/dl to 87.1 for a BP ≥160/100 and HDL-C <40mg/dl. Compared with those with BP <120/80mmHg with either LDL-C <100mg/dl or HDL-C ≥60mg/dl, hazard ratios (HRs) for CVD events were 2.1 when BP ≥160/100mmHg and LDL-C ≥160mg/dl and 2.1 when BP ≥160/100 and HDL-C <40mg/dl (all P< 0.01), with similar results for non-HDL-C. Elevated BP was associated with increased risk across all lipid levels. Increased LDL-C added risk mainly when BP <140/90mmHg, but lower HDL-C also predicted CVD in those with higher BP.ConclusionIncreased BP confers increased risks for CVD in elderly persons across all lipid levels. Although increased LDL-C added risk mainly when BP 140/90mmHg, low HDL-C added risk also in those with hypertension. These results document the importance of combined hypertension and dyslipidemia.

Original languageEnglish (US)
Pages (from-to)161-167
Number of pages7
JournalAmerican Journal of Hypertension
Volume23
Issue number2
DOIs
StatePublished - Feb 2010
Externally publishedYes

Fingerprint

Cardiovascular Diseases
Blood Pressure
Lipids
HDL Lipoproteins
LDL Lipoproteins
Health
Hypertension
Dyslipidemias
Coronary Disease
Angioplasty
Lipoproteins
Longitudinal Studies
Epidemiologic Studies
Stroke
Myocardial Infarction
Incidence

Keywords

  • Blood pressure
  • Cardiovascular disease
  • Dyslipidemia
  • Hypertension
  • Risk factors

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Combined association of lipids and blood pressure in relation to incident cardiovascular disease in the elderly : The cardiovascular health study. / Wong, Nathan D.; Lopez, Victor A.; Roberts, Craig S.; Solomon, Henry A.; Burke, Gregory L.; Kuller, Lewis; Tracy, Russell; Yanez, Norbert; Psaty, Bruce M.

In: American Journal of Hypertension, Vol. 23, No. 2, 02.2010, p. 161-167.

Research output: Contribution to journalArticle

Wong, Nathan D. ; Lopez, Victor A. ; Roberts, Craig S. ; Solomon, Henry A. ; Burke, Gregory L. ; Kuller, Lewis ; Tracy, Russell ; Yanez, Norbert ; Psaty, Bruce M. / Combined association of lipids and blood pressure in relation to incident cardiovascular disease in the elderly : The cardiovascular health study. In: American Journal of Hypertension. 2010 ; Vol. 23, No. 2. pp. 161-167.
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AU - Solomon, Henry A.

AU - Burke, Gregory L.

AU - Kuller, Lewis

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AB - Background Hypertension and dyslipidemia are highly prevalent in the elderly. We studied the combined impact of both conditions on cardiovascular disease (CVD) events.MethodsWe studied 4,311 participants aged 65-98 (61.2% female) from the Cardiovascular Health Study (CHS), a longitudinal epidemiologic study, with no prior CVD. We evaluated the relation of low-density lipoprotein (LDL), high-density lipoprotein (HDL), or non-HDL-cholesterol combined with blood pressure (BP) categories to incident CVDincluding coronary heart disease (CHD) (angina, myocardial infarction (MI), angioplasty, coronary bypass surgery, or CHD death), stroke, claudication, and CVD death over 15 years.ResultsCVD incidence (per 1,000 person years) ranged from 38.4 when BP <120/80mmHg and LDL-C <100mg/dl to 94.8 when BP ≥160/100mmHg and LDL-C ≥160mg/dl, and from 28.9 when BP <120/80mmHg and HDL >60mg/dl to 87.1 for a BP ≥160/100 and HDL-C <40mg/dl. Compared with those with BP <120/80mmHg with either LDL-C <100mg/dl or HDL-C ≥60mg/dl, hazard ratios (HRs) for CVD events were 2.1 when BP ≥160/100mmHg and LDL-C ≥160mg/dl and 2.1 when BP ≥160/100 and HDL-C <40mg/dl (all P< 0.01), with similar results for non-HDL-C. Elevated BP was associated with increased risk across all lipid levels. Increased LDL-C added risk mainly when BP <140/90mmHg, but lower HDL-C also predicted CVD in those with higher BP.ConclusionIncreased BP confers increased risks for CVD in elderly persons across all lipid levels. Although increased LDL-C added risk mainly when BP 140/90mmHg, low HDL-C added risk also in those with hypertension. These results document the importance of combined hypertension and dyslipidemia.

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