Dubbo Study of the elderly: hypertension and lipid levels

Abstract

Untreated hypertension in age groups below 60 years has been shown to be associated with significant elevations in serum cholesterol and triglyceride levels. Drug therapy of hypertension has also been shown to have adverse effects on lipoproteins. We have investigated lipid and lipoprotein levels in a community-based sample of men and women 60 years and older belonging to one of the following groupings: (a) normal blood pressure ( n = 1075); (b) untreated hypertension ( n = 329); (c) drug-treated hypertension ( n = 880). Serum lipid, lipoprotein, apolipoprotein or plasma glucose levels did not vary significantly between untreated hypertensives and normotensives of either sex. In a multiple regression model controlling for possible influences of age, overweight, alcohol and tobacco usage, and presence of coronary heart disease, anti-hypertensive drug therapy significantly predicted increased serum triglycerides ( P < 0.001) and reduced high density lipoprotein (HDL) cholesterol levels ( P < 0.01) in both sexes, reduced apolipoprotein A-I levels in males ( P < 0.001), and increased apolipoprotein B ( P < 0.01) and plasma glucose levels ( P < 0.001) in females. Adjusted triglycerides were 20% higher and HDL cholesterol was 7% lower in the presence of anti-hypertensive drug therapy. These effects were partially consistent with the known actions of thiazide diuretics and beta-blockers which were used by more than 50% and 40% of subjects, respectively.