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Relevance in the Therapy of Hypertension and Coronary Heart Disease

Balkrishna M. Singh, MD; Jawahar L. Mehta, MD, PhD

Arch Intern Med. 2003;163:1296-1304.

Dyslipidemia and hypertension are frequently observed in patients with ischemic heart disease. Studies from a number of laboratories suggest up-regulation of different components of the renin-angiotensin system (RAS) in patients with hypertension and atherosclerosis. Lipid accumulation in the blood vessels enhances the expression of RAS components; on the other hand, activation of RAS stimulates accumulation of low-density lipoproteins, particularly the oxidatively modified form, in the blood vessels. This concept of cross-talk between dyslipidemia and RAS activation has been proven in laboratory-based studies. Clinical trials also suggest that blockade of dyslipidemia and RAS may have a synergistic salutary effect on the outcome of patients with hypertension and/or manifestations of atherosclerosis. This concept needs to be evaluated in large clinical studies.

From the Division of Cardiovascular Medicine, Department of Internal Medicine, University of Arkansas for Medical Sciences, and the Central Arkansas Veterans Healthcare System, Little Rock. The authors have no relevant financial interest in this article.

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