DYSLIPIDEMIA IN TREATED AND UNTREATED PATIENTS WITH HYPERTENSION, DIABETES OR BOTH

Abstract

Abstract Objective: We investigated the prevalence of dyslipidemia in patients with hypertension and diabetes mellitus alone or both and the association between dyslipidemia and the use of antihypertensive and antidiabetic agents. Methods: Our study participants were treated and untreated hypertensive and diabetic patients enrolled in a China nationwide registry. Dyslipidemia was defined as a serum concentration of triglycerides ?2.3 mmol/L, total cholesterol ?6.2 mmol/L, low-density lipoprotein (LDL) cholesterol ?4.1 mmol/L and high-density lipoprotein (HDL) cholesterol ?1.00 mmol/L. Design and method: Serum triglycerides and HDL cholesterol, but not total and LDL cholesterol were significantly different between patients with hypertension alone (n = 860), diabetes alone (n = 473) or both (n = 1090). The prevalence of dyslipidemia was not significantly different between patients with hypertension and diabetes or both for either component or overall (P = 0.34), except that in the subgroup younger than 50 years of age. It was higher in patients with hypertension and diabetes than those with either disease alone. However, treated, compared with untreated hypertensive patients had significantly lower serum total, LDL and HDL cholesterol, and similar serum triglycerides. And treated, compared with untreated diabetic patients had significantly lower serum triglycerides, total and LDL cholesterol but similar HDL cholesterol. The result remained similar for various forms of dyslipidemia. After adjustment for confounding factors, the results were confirmatory, with a significantly odds ratio of 0.76 (95% CI 0.58 - 0.997, P = 0.048) for hypercholesterolemia and 1.56 (95% CI 1.19 - 2.03, P = 0.001) for low HDL cholesterol associated with antihypertensive treatment, and of 1.50 (95% CI 1.18 - 1.89, P = 0.0008) for low HDL cholesterol associated with antidiabetic treatment. Further analyses showed that the odds for low HDL cholesterol was significantly (P?0.02) higher with the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (n = 927), diuretics/?-blockers (n = 547) and insulin (n = 460). Results: The prevalence of dyslipidemia was only sightly different between patients with hypertension and diabetes mellitus alone or both, but differed significantly between treated and untreated hypertension and diabetes in favour of treatment in spite of some compromise in HDL cholesterol with the use of some of medications.