Blood Pressure and Cholesterol Control in Hypertensive Hypercholesterolemic Patients: National Health and Nutrition Examination Surveys 1988–2010
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Background—: Hypertension doubles coronary heart disease (CHD) risk. Treating hypertension only reduces CHD risk ≈25%. Treating hypercholesterolemia in hypertensive patients reduces residual CHD risk >35%. Methods and Results—: To assess progress in concurrent hypertension and hypercholesterolemia control, National Health and Nutrition Examination Surveys 1988 to 1994, 1999 to 2004, and 2005 to 2010 were analyzed. Hypertension was defined by blood pressure ≥140/≥90 mm Hg, current medication treatment, and 2-told hypertension status; blood pressure <140/<90 defined control. Hypercholesterolemia was defined by ATP III criteria based on 10-year CHD risk, low-density lipoprotein cholesterol (LDL-C), and non–high-density lipoprotein cholesterol; values below diagnostic thresholds defined control. Across surveys, 60.7% to 64.3% of hypertensives were hypercholesterolemic. From 1988 to 1994 to 2005 to 2010, control of LDL-C rose (9.2% [95% confidence interval (CI), 6.6%–11.9%] to 45.4% [95% CI, 42.6%–48.3%]), concomitant hypertension and LDL-C (5.0% [95% CI, 3.3%–6.7%] to 30.7% [95% CI, 27.9%–33.4%]), and combined hypertension, LDL-C, and non–high-density lipoprotein cholesterol (1.8% [95% CI, 0.4%–3.2%] to 26.9% [95% CI, 24.4%–29.5%]). By multivariable logistic regression, factors associated with concomitant hypertension, LDL-C, and non–high-density lipoprotein cholesterol control (odds ratio [95% CI]) were statin (10.7 [8.1–14.3]) and antihypertensive (3.32 [2.45–4.50]) medications, age (0.77 [0.69–0.88]/10-year increase), ≥2 healthcare visits/yr (1.90 [1.26-2.87]), black race (0.59 [0.44–0.80]), Hispanic ethnicity (0.62 [0.43–0.90]), cardiovascular disease (0.44 [0.34–0.56]), and diabetes mellitus (0.54 [0.42–0.70]). Conclusions—: Despite progress, opportunities for improving concomitant hypertension and hypercholesterolemia control persist. Prescribing antihypertensive and antihyperlipidemic medications to achieve treatment goals, especially for older, minority, diabetic, and cardiovascular disease patients, and accessing healthcare at least biannually could improve concurrent risk factor control and CHD prevention.
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Approximately half of treated patients do not have adequate blood pressure or glycemic control.
“Despite the widespread availability of effective treatments, approximately half of treated patients do not have adequate blood pressure (BP) or glycemic control [4,6,7].”
From Effectiveness of Digital Medicines to Improve Clinical Outcomes in Patients with Uncontrolled Hypertension and Type 2 Diabetes: Prospective, Open-Label, Cluster-Randomized Pilot Clinical Trial (2017) · cites this paper as [6]
The Results (page not provided) report that 66% of hypertensive patients were treated and 21.5% were treated but had uncontrolled blood pressure—about one-third of treated patients, not approximately half. The approximately half figure (46%) applies to all hypertensive patients, including untreated patients. The paper examines cholesterol control, not glycemic control. (LLM, conf=0.88)
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- Authors
- Egan, B. M., Li, J., Qanungo, S., & Wolfman, T. E.
- Affiliations
- Medical University of South Carolina (US)
- Venue
- Circulation
- Published
- 2013-07-02
- Volume
- 128
- Issue
- 1
- Pages
- 29-41
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC4066305
- OpenAlex
- W1963941738
- Cited by
- 150
- References
- 51
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 7 · 2023: 6 · 2022: 8 · 2021: 12 · 2020: 8 · 2019: 15 · 2018: 6 · 2017: 12 · 2016: 13 · 2015: 18 · 2014: 22 · 2013: 4
- FWCI
- 12.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R34HL105880, R01HL091841, HL091841, HL105880)
- National Institute of Neurological Disorders and Stroke (NS058728, U01NS058728)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- hypertension, hypercholesterolemia, blood pressure control, LDL cholesterol control, non-HDL cholesterol, coronary heart disease risk, statin therapy, antihypertensive drugs, health care utilization, cardiovascular risk management, comorbidities, lipid-lowering therapy, antihypertensive therapy, LDL/HDL ratio
- MeSH terms
- Adult, Aged, Blood Pressure, Cholesterol, Coronary Artery Disease, Female, Humans, Hypercholesterolemia, Hypertension, Male, Middle Aged, Nutrition Surveys, Risk Factors, United States, Comorbidity, Multivariate Analysis, Logistic Models
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