How to treat hypertension combined with hyperlipidemia

  Among the “three highs”, hypertension and hyperlipidemia are two very common clinical conditions, and hypertension is generally diagnosed by sphygmomanometry, i.e., systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg measured three times on non-same day without the use of antihypertensive drugs. and diastolic blood pressure <90 mmHg were considered simple systolic hypertension. Patients with a previous history of hypertension and currently on antihypertensive medication were diagnosed with hypertension even though their blood pressure was below 140/90 mmHg. Hyperlipidemia, on the other hand, requires a blood test to diagnose. Blood lipids mainly refer to cholesterol and triglycerides in the blood. Hyperlipidemia is a condition in which the levels of cholesterol, triglycerides and LDL in the blood exceed the normal range and can directly cause a number of serious health hazards, such as atherosclerosis, coronary heart disease, pancreatitis, etc. Hyperlipidemia is commonly known as hyperlipidemia or high blood lipid.  I. Relationship between hypertension and hyperlipidemia.  Both hypertension and dyslipidemia are important risk factors for atherosclerotic cardiovascular diseases, and patients with hypertension accompanied by dyslipidemia have a significantly increased risk of cardiovascular and cerebrovascular disease events. Therefore, for patients with hypertension combined with hyperlipidemia, combined antihypertensive and lipid-lowering therapy is particularly important.  Treatment of hypertension and dyslipidemia For hypertensive patients with dyslipidemia, active control of lipids can reduce the risk of cardiovascular disease in hypertensive people. In this regard, China's dyslipidemia prevention and treatment guidelines specify that the ideal cholesterol level for primary prevention of atherosclerotic cardiovascular disease in China is LDL cholesterol (bad cholesterol) <2.6 mmol/L (non-HDL cholesterol <3.4 mmol/L). Numerous randomized controlled clinical trials have shown that statin lipid-lowering therapy significantly reduces all-cause mortality and the risk of cardiovascular events in patients with hypertension combined with dyslipidemia, and suggest that low-to-moderate intensity statins are safe and effective for primary prevention in patients with hypertension combined with dyslipidemia. However, not all patients with hypertension need to receive statins as a primary prevention strategy for cardiovascular events (i.e., prevention in patients with risk factors for cardiovascular disease who have not yet had an episode of cardiovascular disease). Analysis of available data shows that low to moderate intensity statin therapy significantly reduces cardiovascular risk in patients at intermediate or high risk of cardiovascular disease, including those with hypertension, and is safe and well tolerated. Statins should be considered in hypertensive patients in the following situations: hypertension combined with ≥1 metabolic risk factor or with target organ damage should be treated with statins as primary prevention of cardiovascular disease; hypertension combined with clinical disease (including cardiac, cerebral, renal and vascular) should be treated with statins as secondary prevention. Patients with hypertension applying statins as primary prevention can use low-intensity statins; if combined with multiple risk factors (such as diabetes, obesity, smoking, advanced age, etc.) or more serious target organ damage, moderate-intensity statins can be used. Patients with hypertension should be treated with statins as secondary prevention, with medium-intensity statins as initial treatment and high-intensity statins or statins combined with other lipid-lowering drugs if necessary.  In addition to the above drug treatment, lifestyle improvement, low salt and low fat diet should be used as the basic treatment for lowering blood pressure and lipids, which is especially important for patients with hypertension with dyslipidemia.