[Arterial hypertension associated with hyperlipoproteinemia].
Hypertension and serum cholesterol levels are strongly interrelated as cardiovascular risk factors. The Framingham study showed that the risk of both ischaemic heart disease and brain infarction doubles in presence of mild hypertensive status and triplicates in presence of a definitive hypertension. The systolic pressure showed to be the best predictor of both ischaemic heart disease and cerebral infarction particularly in persons aged more than 65 years. In terms of physiopathology we point out several mechanisms by which hypertension could interact with hypercholesterolemia on the arterial wall causing endothelial lesion, enhancing the penetration of arterial wall by lipoproteins, calcium accumulation on smooth subendothelial muscle and suppression of the relaxation factor produced by endothelial cells. In relation to the dietetic treatment, we must restrict more rigorously the ingestion of salt, saturated fatty acids, and total calories. In terms of anti-hypertensive drugs, we should: Avoid thiazide diuretics in case of cholesterol levels of moderate to high risk. Avoid beta blockers in patients with high levels of triglycerides, low HDL and low ratio total cholesterol/HDL. Consider to choose a calcium antagonist, a converting enzyme or an alpha blocker.
Domingues
J
J
Centro de Saúde de Almada e Investigador, Centro Policlínico de Almada.
Esteves
A
A
Santos
A
A
Carrageta
M
M
D006801:Humans; D006951:Hyperlipoproteinemias / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy
Hipertensão arterial com hiperlipoproteinémia associada.