Ethnic and Sex Differences in the Prevalence, Treatment, and Control of Dyslipidemia Among Hypertensive Adults in the GENOA Study

O’Meara, John G.; Kardia, Sharon L.R.; Armon, Jeffrey J.; Brown, C. Andrew; Boerwinkle, Eric; Turner, Stephen T.

doi:10.1001/archinte.164.12.1313

Cited by 167 publications

(118 citation statements)

References 31 publications

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“…This is confirmed by estimates of the prevalence of dyslipidaemia in hypertensive patients in surveys and studies of electronic medical records which range from approximately 20 to 50%. 3,4,[7][8][9][10] In the GPRD, we also found a low prevalence of recording for other cardiovascular risk factors. In UK general practice, screening for the presence of diabetes 33 and proteinuria 34 is not routinely performed.…”

Section: Discussionmentioning

confidence: 99%

“…Hypertension seldom occurs in isolation from other risk factors and is often accompanied by conditions such as glucose intolerance, obesity, left ventricular hypertrophy and dyslipidaemia (including elevated total cholesterol and elevated lowdensity lipoprotein cholesterol). 1 The clustering of multiple cardiovascular risk factors in individuals is common, [1][2][3][4] and it has been observed that the impact of concurrent risk factors on cardiovascular disease (CVD) is more than additive. 5,6 Dyslipidaemia is found in a high proportion of hypertensive patients, 4,[7][8][9][10][11] and the presence of both conditions results in a significant increase in the risk of CVD.…”

Section: Introductionmentioning

confidence: 99%

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Treatment patterns of hypertension and dyslipidaemia in hypertensive patients at higher and lower risk of cardiovascular disease in primary care in the United Kingdom

2007

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Few studies have investigated the presence of dyslipidaemia in hypertensive individuals. In addition, few data exist on the concurrent treatment of both conditions for the prevention of cardiovascular disease (CVD). This retrospective cohort study examined treatment patterns for hypertension and dyslipidaemia among hypertensive patients in UK primary care. We defined a population of patients aged X40 years from the UK General Practice Research Database. Hypertensive individuals with X3 additional cardiovascular risk factors (ARFs) were compared with a cohort comprising hypertensive patients with p2 ARFs. We analysed the prevalence of risk factors and the prevalence and incidence of treatment for hypertension, dyslipidaemia and for both conditions between January 1997 and December 2001. A total of 117 840 hypertensive patients were identified (23 655 with X3 ARFs, 94 185 with p2 ARFs) in 1997; in 2001, the number diagnosed as hypertensive was 133 683 (40 248 X3 ARFs, 93 435 p2 ARFs). The prevalence of antihypertensive treatment in the hypertensive patients with X3 ARFs increased during the study. In 2001, approximately one-third of hypertensive patients with X3 ARFs were not receiving antihypertensives. Among those patients who received such treatment, the majority received X2 separate agents in accordance with current guidelines. Treatment for concurrent hypertension and dyslipidaemia was initiated in o8% of patients with hypertension and X3 ARFs in each year. These findings demonstrate the under-recognition/undertreatment of cardiovascular risk factors in UK primary care among patients at risk of CVD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment patterns of hypertension and dyslipidaemia in hypertensive patients at higher and lower risk of cardiovascular disease in primary care in the United Kingdom

2007

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“…14 Recruitment and subject characteristics in Phase I 15 and Phase II 16 of the GENOA study have been previously described. All the participants for the present study were non-Hispanic white subjects residing in Olmsted County, MN, USA.…”

Section: Study Populationmentioning

confidence: 99%

Urinary albumin excretion is associated with impaired flow- and nitroglycerin-mediated brachial artery dilatation in hypertensive adults

et al. 2007

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We investigated whether the urinary albumin/creatinine ratio (UACR), a measure of albuminuria, is associated with non-invasive measures of arterial function in hypertensive adults without known coronary heart disease (CHD) or stroke. UACR was measured in the first voided morning urine sample in 469 non-Hispanic white hypertensive individuals (mean age 62.279.8 years, 41% men) belonging to hypertensive sibships. High-resolution ultrasonography of the brachial artery was used to assess flow-mediated dilatation (FMD) -an endothelium-dependent response -and nitroglycerin-mediated dilatation (NMD) -an endothelium-independent response. Because of skewed distribution, UACR was log transformed after addition of 0.1. The association of log (UACR þ 0.1) with FMD and NMD, before and after adjustment for CHD risk factors, serum creatinine, and hypertension medication and statin use was assessed using linear regression analyses. In univariable analyses, variables associated with lower FMD were greater age, male sex, history of smoking, lower high-density lipoprotein (HDL) cholesterol, higher serum creatinine and higher log (UACR þ 0.1); variables associated with lower NMD were greater age, male sex, higher systolic blood pressure, lower HDL cholesterol, higher serum creatinine and higher log (UACR þ 0.1). In separate stepwise multivariable regression analyses that adjusted for conventional CHD risk factors, serum creatinine and hypertension medication and statin use, higher log (UACR þ 0.1) was associated with lower brachial artery FMD (P ¼ 0.035) and NMD (P ¼ 0.0002). These findings highlight the association of increased urinary albumin excretion with impaired vascular reactivity in hypertensive individuals.

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“…Serum creatinine, glucose, total cholesterol, HDL cholesterol, and triglyceride concentrations and urine albumin, total protein, and creatinine concentrations were measured by standard methods on a Hitachi 911 Chemistry Analyzer (Roche Diagnostics, Indianapolis, IN) (13,14). The eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) equation: eGFR ϭ 186.3 ϫ (serum creatinine)…”

Section: Laboratory Measurementsmentioning

confidence: 99%

Influence of Genomic Loci on Measures of Chronic Kidney Disease in Hypertensive Sibships

Turner¹,

Kardia²,

Mosley³

et al. 2006

Journal of the American Society of Nephrology

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Genomewide linkage analyses were conducted of serum creatinine, estimated GFR (eGFR), and urine albumin-creatinine ratio (UACR) in search of genetic susceptibility loci for chronic kidney disease in 1351 black (median age 63 yr, 70% women, 79% hypertensive) and 1022 white individuals (median age 61 yr, 56% women, 75% hypertensive) from sibships in which two or more members had essential hypertension diagnosed before age 60 yr. After adjustment for gender, age, diabetes, and use of angiotensin inhibitors, the logarithm-transformed measure of serum creatinine was heritable in both ethnic groups (0.45 in black individuals [P < 0.001]; 0.39 in white individuals [P < 0.001]), as was eGFR (0.52 in black individuals [P < 0.001]; 0.39 in white individuals [P < 0.001]). Log UACR was heritable in black individuals (0.30, P < 0.001) but not in white individuals (0.12; P ‫؍‬ 0.059). In black individuals, the univariate maximum multipoint logarithm of odds scores (MLS) were observed on chromosome 7 for log serum creatinine (MLS ‫؍‬ 3.65, at 43 cM from pter; P ‫؍‬ 0.00002) and eGFR (MLS ‫؍‬ 2.52, at 45 cM from pter; P ‫؍‬ 0.00033) and for log UACR (MLS ‫؍‬ 2.91, at 112 cM from pter; P ‫؍‬ 0.00012). In white individuals, only one MLS for log serum creatinine and one for eGFR achieved the logarithm of odds score criterion for "suggestive" evidence of linkage (2 < MLS < 3), both on chromosome 3 (at 211 and 209 cM, respectively); however, none did so for log UACR. In black individuals, bivariate linkage analyses of log serum creatinine and pulse pressure (i.e., systolic-diastolic BP) provided "suggestive" evidence of a region on chromosome 5 with pleiotropic effects on both traits (MLS ‫؍‬ 3.62, at 85 cM from pter; P ‫؍‬ 0.00023). These findings support the utility of genetic linkage analyses for identification of novel risk factors that influence measures of chronic kidney disease, particularly among black individuals.

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Ethnic and Sex Differences in the Prevalence, Treatment, and Control of Dyslipidemia Among Hypertensive Adults in the GENOA Study

Cited by 167 publications

References 31 publications

Treatment patterns of hypertension and dyslipidaemia in hypertensive patients at higher and lower risk of cardiovascular disease in primary care in the United Kingdom

Treatment patterns of hypertension and dyslipidaemia in hypertensive patients at higher and lower risk of cardiovascular disease in primary care in the United Kingdom

Urinary albumin excretion is associated with impaired flow- and nitroglycerin-mediated brachial artery dilatation in hypertensive adults

Influence of Genomic Loci on Measures of Chronic Kidney Disease in Hypertensive Sibships

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