ABSTRACT

Hypertensive patients have a higher prevalence of dyslipidaemia than normotensive individuals with comparable characteristics in terms of age, sex and race. Both hypertension and dyslipidaemia may promote endothelial dysfunction, with a loss of normal structure and regulatory function of the vessel walls. Essential hypertension promotes the development and accelerates the progression of atherosclerosis at multiple vascular districts, thus favouring the occurrence of major cardiovascular (CV) events, including myocardial infarction, coronary events, ischaemic stroke and CV death. The chapter discusses the pathophysiological and clinical consequences of dyslipidaemia in hypertensive patients at different CV risk profiles, thus highlighting the need for approaching individual global CV risk profiles rather than reducing absolute levels of blood pressure (BP) or plasma cholesterol in asymptomatic subjects at high risk of experiencing major CV events. A meta-analysis of eight controlled, lipid-lowering trials involving 18,000 patients has shown a reduction of systolic BP between 1.3 and 6 mmHg in subjects who received lipid-lowering treatment.