High cholesterol, high
blood pressure
deadly combination for stroke
Newswise — Whether you are male,
female, White, or Black, if you have high blood pressure and high
cholesterol, you are at greater risk of heart disease and stroke
than those without these combined conditions.
Data released today from ISHIB2005
and a study conducted by Daniel T. Lackland, DrPH from the Medical
University of South Carolina indicate that a significant number of
adults have elevated blood pressure and elevated cholesterol. These
combined conditions were found to increase health risks for heart
disease and stroke in all populations.
In this analysis of US-based
epidemiologic cohort studies, Black men and women had the highest
values of total cholesterol, with 13.9% of Black women and 8.5% of
Black men having the highest combined rates of systolic blood
pressure (SBP) and total cholesterol (TC), compared to 7.6% and 5.0%
for White women and men, respectively. The greatest disease risk was
identified with the highest categories of SBP and TC for all four
race-sex groups. The greatest risks for the higher levels and the
higher prevalence of elevated SBP and TC for Black men and women
increase the disease burden. These results emphasize the need for
all segments of the population, with particular focus on Black men
and women, to treat and control SBP and TC in order to reduce the
cardiovascular disease outcomes.
The study, known as the Black
Pooling Project, emphasizes the need for control of high cholesterol
and hypertension to significantly reduce the incidence of stroke and
cardiovascular disease. In previous studies, high cholesterol has
been established as a risk factor for coronary artery disease,(1-3)
but it has not been consistently considered a risk factor for
stroke. Recently, however, a study by Horenstein et al, found that
cholesterol levels could predict stroke mortality among women.(4)
Lackland’s study shows that the combined risk factors of cholesterol
levels as well as high blood pressure put both men and women from
all populations in double jeopardy for heart disease.
“The occurrence of these combined
conditions indicates an acute need for early diagnosis and
aggressive treatment,” stated Dr. Lackland. “While other studies
have shown similar findings, this study is the largest of its kind
and covers a longer follow-up period to provide more accurate
comparisons between males/females as well as among ethnic groups.”
To conduct this study, Lackalnd
and colleagues performed a person-level, analysis by examining large
US epidemiologic studies with both Black and White cases.
Black-White comparisons were performed on coronary heart disease (CHD)
incidence and mortality, exposure-outcome relationship, patterns of
co-morbidity, and population attributable risks. Studies included in
the analysis were: the First National Health and Nutrition
Examination Survey (NHANES I) Epidemiological Follow-up Study; the
NHANES II Mortality Follow-up Study; the Charleston Heart Study; and
the Evans County Heart Study.
Although death rates from CHD have
declined for all major demographic groups of the US population over
the past three decades, a recent slowing of the decline has been
seen among Blacks and among women. Because many studies had small,
if any, samples including Blacks, comparisons between Black-White
differences could not be made with accuracy. The current study
addressed this absence of data and represented all four major
groups: Black men and women and White men and women.
The Black Pooling Project provided
a total sample of 26,913: 1,934 Black men; 2,725 Black women; 9,888
White men; and 12,366 White women.
The Black Pooling Project is a clinical trial funded by the National
Heart, Lung, and Blood Institute of the National Institute of Health
at the Department of Health and Human Services. Principal
investigator is Daniel T. Lackland, DrPH and the sponsoring
institution is the Medical University of South Carolina in
Charleston, South Carolina.
These research findings were
presented at ISHIB2005. The abstract was a blue ribbon presentation
during ISHIB2005 Plenary Session I at 1:00 PM, July 16, 2005.
ISHIB2005, an annual gathering of healthcare professionals from
around the world, is jointly sponsored by the nonprofit ISHIB and
ASH (American Society on Hypertension) and is taking place at the
Caribe Hilton Hotel in San Juan, Puerto Rico during July 15-18.
ISHIB (the International Society
on Hypertension in Blacks) is a unique professional medical
membership organization devoted to improving health and life
expectancy of ethnic populations. ISHIB was founded in Atlanta,
Georgia, in 1986 to respond to the problem of high blood pressure
among ethnic populations. Each year, its international
interdisciplinary conference presents advancements in the treatment
and prevention of diseases concomitant to hypertension. In addition
to US conference locations, other sites for the conference have
included Toronto, London, the US Virgin Islands, Kenya, Cameroon and
Brazil.