European Heart Journal Advance Access originally published online on February 28, 2008
European Heart Journal 2008 29(20):2561-2568; doi:10.1093/eurheartj/ehn061
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Dyslipidaemia as a predictor of hypertension in middle-aged men
1 Department of Medicine, Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland
2 Department of Physiology, Institute of Biomedicine, University of Kuopio, Kuopio, Finland
3 Research Institute of Public Health, University of Kuopio, Kuopio, Lapland Central Hospital, Rovaniemi, Finland
4 Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
5 Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland
6 Oy Jurilab Ltd, Kuopio, Finland
Received 16 August 2007; revised 16 December 2007; accepted 23 January 2008; online publish-ahead-of-print 28 February 2008.
* Corresponding author. Tel: +358 17 173311, Fax: +358 17 173790, Email: david.laaksonen{at}uku.fi
Aims: Dyslipidaemia and hypertension are features of the metabolic syndrome, but the role of dyslipidaemia in the development of hypertension is less clear. We assessed the association of dyslipidaemia with incident hypertension during a 7-year follow-up in a population-based cohort of middle-aged men without hypertension at baseline.
Methods and results: In all, 88 of 311 men developed hypertension during the follow-up. A 1-SD increment in triglyceride concentrations was associated with a 1.6-fold [95% CI(confidence interval) 1.2–2.3] increased risk of developing hypertension, independently of features related to the metabolic syndrome. In separate multivariable models, the triglyceride content of high-density lipoprotein (HDL) cholesterol and apolipoprotein B concentrations were also associated with new-onset hypertension. In a stepwise backwards logistic regression model, concentrations of low-density lipoprotein (LDL) cholesterol [odds ratio (OR) 1.3, 95% CI 1.0–1.7 for a 1-SD change] and triglyceride content of HDL cholesterol (OR) 1.5, 95% CI 1.1–1.9) were positively associated with incident hypertension, whereas HDL concentrations (OR 0.7, 95% CI 0.5–0.9) seemed protective. In factor analyses, elevated triglyceride levels and related disturbances in lipid and cholesterol metabolism were associated with new-onset hypertension.
Conclusion: Dyslipidaemia characteristic of the metabolic syndrome predicts the development of hypertension during a 7-year follow-up of eastern Finnish men, independently of features related to insulin resistance. The recognition of dyslipidaemia and initiation of lifestyle treatment even in the absence of hypertension is likely to reduce the long-term burden of cardiovascular disease.
Key Words: Hypertension • Lipoproteins • Apolipoproteins • Triglycerides • Lipoprotein triglycerides • Cohort studies