Control High Cholesterol and High Blood Pressure to have a Healthy Heart

Dyslipidaemia and raised blood pressure or hypertension are important risk factors for heart disease.¹ Dyslipidaemia is a disorder of lipoprotein metabolism involving excessive or deficient production of lipoproteins.² Hypertension or high blood pressure is defined as systolic and diastolic numbers  greater than 140/90 mm of mercury (Hg).³

Several studies have indicated that the simultaneous presence of hypertension and dyslipidaemia has adverse effects on the endothelium (the innermost lining) of the blood vessels, which primarily leads to heart disease.⁴

What happens in dyslipidaemia?

In dyslipidaemia, there are low levels of high-density lipoproteins (HDL) or good cholesterol, high levels of low-density lipoproteins (LDL) or bad cholesterol and high levels of triglycerides. This causes fatty deposits to build up in the arteries.⁵ The fatty deposits called plaques restrict blood flow through the arteries and harden them. Eventually, this causes a strain on the heart while pumping the blood. This is the main cause of several heart conditions including high blood pressure.⁶

What is the association between dyslipidaemia and hypertension?

Both dyslipidaemia and hypertension are the major risk factors of serious heart conditions worldwide.⁴ Scientists have proposed several mechanisms that relate hypertension with dyslipidaemia. These are discussed below:

• Plaque that sticks to the inner walls of the arteries of the heart in dyslipidaemia exerts pressure on the heart, which raises the blood pressure to abnormally high values.⁶
• Dyslipidaemia causes loss of vasomotor activity (actions that affect the diameter of blood vessels) and damage to the endothelium. This damage can lead to high blood pressure.⁴
• Dyslipidaemia and hypertension show an association due to common reasons such as obesity.¹

From studies, the relationship between   the changes in the arteries due atherosclerosis (deposition of plaque in the arteries) caused by dyslipidaemia and the  the regulation of blood pressure in individuals maybe seen.¹

Why is the management of dyslipidaemia and hypertension important?

Studies have stated that the coexistence of dyslipidaemia and hypertension in people even in moderation has an enhanced adverse effect on the risk of coronary heart disease. The effect seen in people having hypertension and dyslipidaemia was more severe compared to those with only hypertension.¹ Hence, it is essential to control both conditions.

How are dyslipidaemia and hypertension managed?

Evidence suggests that persons with hypertension with dyslipidaemia are at a greater risk of heart disease. Doctors recommend regular medical check-ups and changes in lifestyle to control high cholesterol and high blood pressure.⁷ It is necessary to take immediate steps to identify and treat hypertension and dyslipidaemia for reducing the risk of cardiovascular diseases.⁴

• Hypertension is treated with a single drug or multiple drugs that involve different classes of medicines to lower the increased blood pressure.⁸ Doctors prescribe statins as cholesterol-lowering drugs.⁴
• Statins, in combination with anti-hypertensive drugs, have shown improved control of blood pressure. Similar to lipid-lowering drugs showing a better control of blood pressure in patients with high blood pressure , some blood pressure-lowering drugs have an effect on serum lipid levels.⁴
• According to studies, a low-fibre diet and physical inactivity may lead to obesity and dyslipidaemia, thereby increasing blood pressure. Hence, lifestyle modifications can be beneficial for both conditions. A fibre-rich diet, low intake of saturated fat and less carbohydrate intake can lower both serum lipid levels and blood pressure.⁷
• Stopping the use of tobacco and increasing physical activity can help lower blood pressure and cholesterol.⁴

The parallel treatment of dyslipidaemia and high blood pressure can successfully control both conditions, thereby reducing the risk of adverse effects on the heart.⁴

Your health is in your hands. Have regular check-ups. Early detection and prompt treatment can help you control cholesterol in the blood, thus avoiding the development of blood pressure and other heart conditions.⁷

Control high cholesterol and high blood pressure and have a healthy heart!

References:

1. Otsuka T, Takada H, Nishiyama Y, Kodani E, Saiki Y, Kato K. Dyslipidemia and the risk of developing hypertension in a working-age male population. J Am Heart Assoc. 2016 Mar 25;5(3) 5:e003053 doi: 10.1161/JAHA.115.003053.
2. Ahmed SM, Clasen ME, Donnelly JF. Management of dyslipidemia in adults. Am fam physician. 1998 May 1;57(9):2192-2204.
3. NHS. High Blood Pressure (Hypertension). [Internet]. [updated 2019 Oct 23; cited 2019 Dec 30]. Available from: https://www.nhs.uk/conditions/high-blood-pressure-hypertension/
4. Dalal JJ, Padmanabhan TNC, Jain P, Patil S, Vasnawala A, Gulati A. LIPITENSION: Interplay between dyslipidemia and hypertension. Indian J Endocrinol Metab. 2012; 16(2):240-245.
5. Hormone Health Network. Dyslipidemia. [Internet]. [updated 2018 May; cited 2019 Dec 30]. Available from: https://www.hormone.org/diseases-and-conditions/dyslipidemia
6. Cleveland Clinic. Diseases caused by high cholesterol [Internet]. [updated 2016 Dec 12] Available from: https://my.clevelandclinic.org/health/articles/11918-cholesterol-high-cholesterol-diseases
7. Ariyanti R and Besral B. Dyslipidemia associated with hypertension increases the risks for coronary heart disease: A case-control study in harapan kita hospital, national cardiovascular center, Jakarta. Journal of Lipids. 2019. https://doi.org/10.1155/2019/2517013
8. Yan X, et al. Blood pressure and low-density lipoprotein cholesterol control status in Chinese hypertensive dyslipidemia patients during lipid-lowering therapy. Lipids in Health and Disease. 2019;18(32). https://doi.org/10.1186/s12944-019-0974-y

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