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Howard D. Sesso, ScD, MPH; Julie E. Buring, ScD; Marilyn J. Chown, BSN, MPH; Paul M Ridker, MD, MPH; J. Michael Gaziano, MD, MPH

Arch Intern Med. 2005;165:2420-2427.

Background  Although dyslipidemia and hypertension occur together more often than can be explained by chance, few studies have carefully explored the nature of the relationship between plasma lipid levels and the risk of developing hypertension.

Methods  We conducted a prospective study of 16 130 middle-aged and older female health professionals in 1992 who provided baseline blood samples and had no history of high cholesterol level (no treatment or diagnosis) or hypertension (no treatment, diagnosis, or elevated blood pressure). Plasma lipid levels were measured, and baseline risk factors were collected. Incident hypertension included a new physician diagnosis, the initiation of antihypertensive treatment, systolic blood pressure of 140 mm Hg or greater, or diastolic blood pressure of 90 mm Hg or greater.

Results  During 10.8 years of follow-up, incident hypertension developed in 4593 women. In multivariate-adjusted models, the relative risks of development of hypertension from the lowest (referent) to the highest quintile of baseline total cholesterol level were 1.00, 0.96, 1.02, 1.09, and 1.12 (P = .002 for trend); for low-density lipoprotein cholesterol level, 1.00, 0.97, 1.00, 1.02, and 1.11 (P = .053 for trend); for high-density lipoprotein cholesterol level, 1.00, 0.93, 0.87, 0.87, and 0.81 (P<.001 for trend); for non–high-density lipoprotein cholesterol level, 1.00, 1.06, 1.11, 1.12, and 1.25 (P<.001 for trend); and for the ratio of total to high-density cholesterol, 1.00, 1.10, 1.14, 1.20, and 1.34 (P<.001 for trend). Similar relative risks were noted for Adult Treatment Panel III clinical cut points and after the exclusion of obese or diabetic women.

Conclusion  In this large prospective cohort, atherogenic dyslipidemias were associated with the subsequent development of hypertension among healthy women.

Author Affiliations: Divisions of Preventive Medicine (Drs Sesso, Buring, Ridker, and Gaziano and Ms Chown), Aging (Drs Sesso, Buring, and Gaziano), and Cardiovascular Disease (Drs Ridker), Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School; Department of Epidemiology, Harvard School of Public Health (Drs Sesso and Buring); Department of Ambulatory Care and Prevention, Harvard Medical School (Dr Buring); and Veterans Affairs Boston Healthcare System (Dr Gaziano); Boston, Mass.

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