More than 50 million Americans have high blood pressure . If left untreated, high blood pressure can lead to heart attack , stroke , and a number of other life-threatening conditions.

Dyslipidemia ( cholesterol problems or high triglycerides ), another major risk factor for heart attack and stroke, is reported in 50% to 80% of people with high blood pressure. Having dyslipidemia in addition to high blood pressure not only adds to your risk of having a heart attack or stroke—it multiplies your risk. Luckily, both high blood pressure and dyslipidemia are modifiable risk factors, and can be effectively managed with lifestyle changes and/or medications.

A new study in the June 28, 2004 issue of the Archives of Internal Medicine found that people with high blood pressure are likely to have untreated or insufficiently treated dyslipidemia. And the likelihood of having dyslipidemia in addition to high blood pressure varied significantly between blacks and whites, and between men and women.

About the Study

This study included 1,286 black men and women, and 1,070 white men and women. All participants had high blood pressure, defined as having at least one of the three following criteria:

  • A past diagnosis of high blood pressure and current use of blood pressure medications
  • Systolic blood pressure (the top number) of 140 millimeters of mercury (mm Hg) or higher
  • Diastolic blood pressure (the bottom number) of 90 mm Hg or higher

The participants filled out a questionnaire that assessed their history and risk of heart disease , as well as whether they were taking medications for dyslipidemia. The researchers measured the participants’ height, weight, waist and hip circumferences, and blood pressure. They also took fasting blood samples to measure their total cholesterol, high-density lipoprotein (HDL) cholesterol (the “good” cholesterol), low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol), and triglycerides.

The researchers used these data to determine and compare among ethnic and sex groups the prevalence of dyslipidemia, how frequently dyslipidemia was treated with medications, and how frequently it was adequately controlled.

The Findings

The researchers found that half of the participants had dyslipidemia. The prevalence of dyslipidemia was significantly higher among men than women, and among whites than blacks.

Among the participants with dyslipidemia, fewer than 33% reported that they were taking medications for it. White men were significantly more likely to be taking these medications than white women, and white participants overall were more likely to be taking these medications than black participants.

Of the participants taking medications, only about half had achieved recommended cholesterol levels.

How Does This Affect You?

This study confirms that dyslipidemia is frequent in people with high blood pressure. The findings also suggest that dyslipidemia in people with high blood pressure is often untreated and, even if treated, often not adequately controlled.

The fact that dyslipidemia treatment was more common in certain groups (whites and men) suggests that there is a disturbing problem of differential treatment for cardiovascular disease. Despite the fact that heart disease, for example, is the number one cause of death in both men and women, it has been widely established that cardiovascular risk factors often go undiagnosed and/or untreated in women. The same is true for blacks and whites.

These findings are yet another indication that blacks may be receiving suboptimal treatment for dyslipidemia (and other cardiovascular risk factors), compared to whites. This is especially alarming, since blacks are significantly more likely to have a stroke and heart disease than are whites for a number of reasons.

The results of this study highlight the importance of having regular screenings for your blood pressure, cholesterol, and triglyceride levels, all of which have essentially no symptoms until it’s too late. If you do find out you have high blood pressure or dyslipidemia, ask your doctor about treatments. Controlling your blood pressure and cholesterol levels with lifestyle changes (i.e., exercise, diet changes, weight loss) and/or medications can significantly reduce your risk of having a heart attack or stroke.