Interactions Between Hypertension and Hypercholesterolemia: From Epidemiology to Therapeutic Implications

Hypertension and hyperlipidemia frequently co-exist in the same patients and are responsible for an increase in the extent of cardiovascular risk. The treatment of both risk factors clearly improves the individual risk profile. The possible mechanisms of interaction seem to be related with RAS activation, resulting in endothelial dysfunction and increased oxidative stress. The underlying mechanisms of the interaction between these two risk factors may reveal the development of new treatment strategies to control both factors at the same time. Available data on therapeutic approach of cardiovascular disease risk suggests the use of RAS blocking agents, calcium channel blockers and statins can be particularly appropriated for the prevention of cardiovascular risk in patients with hypertension. These classes of drugs improve endothelial function and protect the vessels wall from atherogenesis. The results of trials carried out with the combination of a statins (atorvastatin) and a calcium channel blocker (amlodipine) clearly support the important of such combination for the achievement of specific targets of treatment in patients with multiple risk factors. Although many preclinical and clinical studies offer positive effects of the combined use of statins and ARBs for patients with increased risk of cardiovascular events, there is yet need for direct evidences of their efficacy in preventing events in high risk patients.