A 1-2 Punch to Heart Disease

Cardiovascular disease risk is halved by controlling high blood pressure and high cholesterol

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Keeping blood pressure and cholesterol in check can prevent the leading cause of death — heart disease. Both, however, can go undetected unless individuals are screened for them.

Many people often don’t realize when they have high blood pressure or high cholesterol. High blood pressure is called the "silent killer," according to the Centers for Disease Control and Prevention (CDC), because it often has no warning signs or symptoms. High cholesterol can be the same way.

Controlling both your high blood pressure and high cholesterol at the same time, however, may cut the risk for heart disease by half or more, according to new research.

"Get screened regularly for high blood pressure and high cholesterol."

Brent Egan, MD, a professor of medicine and pharmacology at Medical University of South Carolina in Charleston, led this study which drew its data from more than 17,000 American adults.

Dr. Egan and colleagues commented that previous research had shown that treating high blood pressure reduces the risk of heart disease by 25 percent and treating high cholesterol in patients with high blood pressure can lower the risk by more than 35 percent.

These researchers observed that treating high blood pressure and high cholesterol at the same time reduced heart disease risk by 50 percent or more.

Going to the doctor at least twice a year may help detect and control these conditions, according to the study.

Sarah Samaan, MD, cardiologist and physician partner at the Baylor Heart Hospital in Plano, Texas, told dailyRx News, "Since both high blood pressure and high cholesterol are usually painless until something catastrophic [like a heart attack or stroke] happens, many people are reluctant to be screened or treated."

This study's authors also noted that prescribing medications to better manage blood pressure and cholesterol would greatly benefit people who are older, diabetic, have cardiovascular disease or are Hispanic or African-American.

Dr. Samaan commented that some people are reluctant to take medication because of potential side effects. "While it is true that a small number of people will have side effects from medications, the majority of people have no problems with medical therapy," she said. "For those who do, we have such a wide range of options that we can usually find a good alternative."

Exercising, maintaining an appropriate body weight and choosing a heart-smart diet may minimize the amount of medication needed, Dr. Samaan said.

Dr. Egan stressed that cholesterol readings need closer attention because a high level of good cholesterol (high-density lipoprotein or HDL) does not cancel out having a high level of bad cholesterol (low-density lipoprotein or LDL).

"Unfortunately, not all HDL is equally protective and some people with a normal HDL are at high risk," said Dr. Egan in a press release.

"In those patients, there might be a false sense of assurance that cholesterol really isn't a problem. But LDL and non-HDL [total cholesterol minus HDL] readings are the ones to really watch," he said. "Patients seeing their doctors for blood pressure treatment should ask about their LDL and non-HDL levels and make sure both are under control at the same time."

Dr. Samaan added, "There is both harmful and beneficial HDL, and conventional tests are not good enough to separate out the two forms. ‘Good’ HDL can even morph into ‘bad,’ or inflammatory, HDL under certain circumstances. That's why LDL and non-HDL are much more predictive of risk."

Non-HDL numbers can be especially predictive of cardiovascular disease because they indicate all the bad cholesterol that is circulating in your blood.

"The reality is, we know more than enough to prevent 75 percent of heart disease and strokes, but we're not doing everything we could be doing or even doing it at a reasonable level," Dr. Egan said. "We've made some gradual improvements over the years, but there is still a lot of progress to be made."

This study was published July 1 in the American Heart Association's journal Circulation.

The CDC, the state of South Carolina and the National Institutes of Health partly funded the study.

Reviewed by: 
Review Date: 
July 1, 2013
Last Updated:
July 31, 2013