Cholesterol goal attainment in hypertensive patients: the impact of metabolic syndrome components.
BACKGROUND
Hypertension and dyslipidemia are potentially modifiable cardiovascular risk factors.


METHODS
We studied hypertensive outpatients regarding goal attainment in controlling dyslipidemia, according to individual cardiovascular risk profile, following the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines. Factors of goal attainment for low-density lipoprotein cholesterol (LDL-C) were determined.


RESULTS
Of the 1,202 patients, this study included 886 (73.8% female, 59.9±11.1 years) with available data to determine cardiovascular risk. Overall, 544 (61.4%) had LDL-C within the goal. Individuals with inappropriate LDL-C were older, had higher systolic blood pressure (SBP), and were more likely to have metabolic syndrome, diabetes, and cardiovascular disease (CVD) and were less likely to show a controlled blood pressure. There was a progressive worsening of LDL-C control as the number of components of metabolic syndrome increased. There was also a progressive increase in the percentage of patients with inappropriate LDL-C with the increase in cardiovascular risk. In a logistic regression model including LDL-C inadequacy as a dependent variable, only age, diabetes, and CVD were predictors of inappropriate LDL-C. Moreover, even with correction for demographic and clinical variables, the inappropriate LDL-C was an independent predictor of CVD.


CONCLUSIONS
The control of dyslipidemia in hypertensive patients is far from ideal and results are even worse in individuals with CVD.
Nephrology, Divisions of the Kidney and Hypertension Hospital, Federal University of São Paulo, São Paulo, Brazil. cjorodrigues@uol.com.br
Cassio José de Oliveira
CJ
Rodrigues
Hercules Ferreira
HF
Ribeiro
Artur Beltrame
AB
Ribeiro
Maria Teresa
MT
Zanella
Marcelo Costa
MC
Batista
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL