Cardiovascular (CV) disease remains the leading cause of death in the United States, claiming more lives each year than the next four leading causes of death combined.1 Clearly, this justifies a search for conditions that contribute to CV disease risk. Hypertension and hyperlipidemia are extremely common conditions that often coexist, and when they do, the odds for cardiac events are multiplied.2,3 For example, in the Framingham Heart Study, when blood pressure (BP) >120 mg/80 mm Hg and cholesterol (total-C) >200 mg/dL coexisted, the risk for CV events increased exponentially. Among men aged 40 to 59 years at baseline who died of coronary heart disease (CHD), 87% had BP >120/80 mm Hg and 92% had a total-C level >200 mg/dL.2 The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), a study of BP- and lipid-lowering in over 19,000 patients, provides compelling new evidence of the importance of aggressive risk factor intervention to prevent major CV events in patients with hypertension.4-7 Previously, Steno-2, a study in 160 patients with diabetes and microalbuminuria, demonstrated that aggressive target-driven treatment to simultaneously lower BP, glucose, total-C, and triglycerides produced a 53% reduction in CV death, nonfatal myocardial infarction (MI) or stroke, revascularization, and amputation over 7.8 years compared with usual care.8 |
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