High Total Cholesterol Linked to High Blood Pressure
A study in Hypertension: Journal of the American Heart Association says men with high total cholesterol are much more likely to develop high blood pressure than men with low total cholesterol.
Hypertension, defined as blood pressure at or higher than 140/90 millimeters of mercury (mm Hg), is the most common chronic disease in the US.
As many as 90 percent of US adults with normal blood pressure at age 55 may develop hypertension in their lifetime, says study author Dr. Howard D. Sesso.
“Hypertension and lipids are both related to the risk of cardiovascular disease,” says Dr. Sesso, associate epidemiologist at Brigham and Women’s Hospital and assistant professor of medicine at Harvard Medical School in Boston.
“We took one step backwards to try to understand whether adverse lipid levels might predate the development of hypertension in men,” explains Dr. Sesso.
Researchers analyzed data from the Physicians’ Health Study, an ongoing clinical trial that collected baseline blood samples of 3,110 men (average age 48) free from hypertension, cardiovascular disease, and cancer at the start of the study.
Over an average of 14 years of follow-up, about one-third (1,019) of the men developed hypertension.
The researchers measured total cholesterol and high-density lipoprotein (HDL, or “good” cholesterol), then calculated non-HDL cholesterol (defined as total cholesterol minus HDL cholesterol) and the ratio of total cholesterol to HDL cholesterol.
“It appears that lipids do have a role in the development of hypertension,” notes Dr. Sesso. “We found a positive association between higher levels of total cholesterol, non-HDL cholesterol, and total cholesterol-to-HDL cholesterol ratio and an increased risk of hypertension.
"Those men who had higher levels of HDL cholesterol had a significantly lower risk for developing hypertension than men who had the low levels of HDL cholesterol,” says Dr. Sesso.
The researchers divided study participants into five groups from the lowest levels to the highest for each lipid category.
They found that men in the:
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highest fifth (quintile) of total cholesterol were 23 percent more likely to develop hypertension than men in the lowest quintile for total cholesterol
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highest quintile of non-HDL cholesterol were 39 percent more likely than those in the lowest quintile to develop hypertension
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highest quintile for total cholesterol-to-HDL cholesterol ratio were at a 54 percent increased risk for hypertension compared with those in the lowest quintile in that category
They also found that men in the highest quintile for HDL levels had a 32 percent lower risk of developing hypertension than those in the lowest quintile.
“When we notice an elevation of lipids in the absence of hypertension, it may indicate those patients are at greater risk of developing hypertension later on,” says Dr. Sesso.
“From an interventional standpoint, those with poor lipid profiles may represent an opportunity to address other risk factors for hypertension and cardiovascular disease,” remarks Dr. Sesso.
Dr. Sesso and his colleagues are further investigating whether lipids have an independent association with developing hypertension or if there might be other explanations to their findings.
Always consult your physician for more information.
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Cholesterol is a waxy substance that can be found in all parts of your body. It aids in the production of cell membranes, some hormones, and vitamin D.
The cholesterol in your blood comes from two sources: the foods you eat and your liver. However, your liver makes all of the cholesterol your body needs.
Cholesterol and other fats are transported in your blood stream in the form of spherical particles called lipoproteins.
The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).
LDL (low-density lipoprotein) cholesterol is commonly called the "bad" cholesterol, and is a type of fat in the blood that contains the most cholesterol.
It can contribute to the formation of plaque buildup in the arteries, known as atherosclerosis.
You want your LDL to be low (less than 130 milligrams per deciliter, or mg/dL). To help lower it:
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avoid foods high in saturated fat, dietary cholesterol, and excess calories
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exercise
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maintain a healthy weight
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stop smoking
In some individuals who already have coronary artery disease (CAD) and/or who have an increased number of risk factors for coronary heart disease, a physician may determine that the LDL cholesterol level should be kept lower than 130 mg/dL.
Recent studies have shown that those who are at highest risk for a heart attack should lower their LDL cholesterol level to less than 100, and that an LDL cholesterol level of 70 or less may be optimal for those individuals at the very highest level of risk.
HDL (high-density lipoprotein) cholesterol is known as the "good" cholesterol, and is a type of fat in the blood that helps to remove cholesterol from the blood, preventing the fatty buildup and formation of plaque.
You want your HDL to be as high as possible (at least 40 mg/dL). Some people can raise HDL by:
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exercising for at least 20 minutes three times a week
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kicking the cigarette habit
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avoiding saturated fat intake
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decreasing body weight
For others, medication may be needed. Because raising HDL is complicated, you should work with your physician on a therapeutic plan.
Always consult your physician for more information.
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