title: Lipoprotein levels are associated with incident hypertension in older adults.
abstract: OBJECTIVE
  To determine the relationship between baseline measures of serum lipoproteins and incident hypertension in older adults.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Pittsburgh, Pennsylvania, site of Systolic Hypertension in the Elderly Program (SHEP).
  
  
  METHODS
  One hundred eighty-seven men and women (mean age 71.3), normotensive (systolic blood pressure (SBP) <160 mmHg, diastolic blood pressure (DBP) <90 mmHg) at baseline, were followed annually over 8 years as an ancillary study to the SHEP.
  
  
  METHODS
  Hypertension development, defined as initiation of antihypertensive therapy or SBP greater than 160 mmHg or DBP greater than 90 mmHg. Lipoprotein measures included total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), HDL(2)-C, HDL(3)-C, triglycerides, and apolipoproteins 1, 2, and B.
  
  
  RESULTS
  Over 8 years, 44 participants developed hypertension, for a Kaplan-Meier cumulative incidence rate of 31% (95% confidence interval (CI)=23-39%). Cumulative incidence rates were highly associated with baseline SBP, ranging from 8% in those with baseline SBP less than 120 mmHg to 70% in those with SBP of 140 to 159 mmHg. Other univariate associations included higher DBP, pulse pressure (P <.01 for both), triglycerides (P=.03), apolipoprotein B (P=.03), and lower HDL-C (P=.04) and HDL(3)-C (P=.02). In multivariate Cox regression analysis, higher baseline SBP (relative risk (RR)=1.8 per 10 mmHg, 95% CI=1.5-2.3) and lower HDL(3)-C (RR=0.8 per 5 mg/dL, 95% CI=0.42-1.0) remained significant independent predictors of time to hypertension.
  
  
  CONCLUSIONS
  Older adults with abnormal serum lipoproteins are at increased risk of developing hypertension. Clinical trials exploring the effects of the modification of lipoprotein levels on hypertension incidence rates are needed.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Wildman
authors.forename: Kim
authors.initials: K
authors.lastname: Sutton-Tyrrell
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.forename: Andrew
authors.initials: A
authors.lastname: Bostom
authors.forename: Sarah
authors.initials: S
authors.lastname: Brockwell
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy; D015994:Incidence; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D008074:Lipoproteins