You already know keeping your blood pressure in check reduces your cardio risks. So does cutting cholesterol. But new research suggests doing both simultaneously can trim your odds of developing heart disease by half or more.
The findings, published in the American Heart Association journal Circulation, suggest more needs to be done to make sure patients with high cholesterol and blood pressure are diagnosed and treated. For doctors, that means making sure their at-risk patients are getting the right medications to better manage their conditions — particularly those who are older, diabetic, have cardiovascular disease, or are Hispanic or African-American.
For patients, it means being more informed about their own health status and seeing a doctor at least twice a year.
"The reality is, we know more than enough to prevent 75 percent of heart disease and strokes, but we're not doing everything we could be doing or even doing it at a reasonable level," said Brent M. Egan, M.D., a professor of medicine and pharmacology at Medical University of South Carolina in Charleston, S.C., who led the study. "We've made some gradual improvements over the years, but there is still a lot of progress to be made."
Dr. Egan said undertreated high blood pressure and cholesterol affects millions of Americans, posing a major public health threat. High blood pressure affects about one in three adults and doubles the risk for heart disease. About 32 million Americans have dangerously high cholesterol levels that also increase their cardio risks.
Past research has shown treating high blood pressure reduces the risk of heart disease by 25 percent and treating high cholesterol in hypertensive patients can lower the risk by more than 35 percent.
The new study’s findings are based on the medical records of more than 17,000 American adults who participated in the National Health and Nutrition Examination Surveys during in 1988-94, 1999-2004, and 2005-10. In addition to reviewing patients' blood pressure and cholesterol levels, researchers examined race, age, insurance status, whether patients smoked, had diabetes, had diagnosed heart disease and/or chronic kidney disease, and if they visited a doctor every year.
"If patients' cholesterol tests show a good high-density lipoprotein [HDL] level, which is the healthy, protective cholesterol, then the low-density lipoprotein [LDL] number might get overlooked," said Dr. Egan. "Unfortunately, not all HDL is equally protective and some people with a normal HDL are at high risk.
"In those patients, there might be a false sense of assurance that cholesterol really isn't a problem. But LDL and non-HDL readings are the ones to really watch. Patients seeing their doctors for blood pressure treatment should ask about their LDL and non-HDL levels and make sure both are under control at the same time."
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