The Impact of Getting Patients with Both Hypertension and High Cholesterol to Target

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Citation
Asia Pacific Cardiology - Volume 2 Issue 1;2008:2(1):33-34

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Overwhelming evidence has been available for decades that classic risk factors such as hypertension and/or dyslipidaemia lead to an increased risk of chronic disease such as heart failure, coronary heart disease, stroke, vascular dementia, chronic kidney disease and peripheral vascular disease. These cardiovascular risk factors and their related diseases are in large part the consequence of an unhealthy lifestyle, which is facilitated by the structure of modern industrialised societies. There is a ready availability of excess calories and workplace-induced inactivity with subsequent obesity, as well as tobacco and alcohol use and excessive sodium consumption.1 Individuals without these unhealthy lifestyles are largely protected from hypertension and dyslipidaemia.2 The implementation of population-based preventative strategies is a major challenge to governments and healthcare services. As individuals have been required to take responsibility for the adverse health consequences of modern society, it is not surprising that inadequate lifestyle intervention is a major barrier to improved outcomes.
The global impact on health policy and the economic burden of hypertension-related disease alone is astounding.3 Up to one billion people are hypertensive (with this figure expected to rise by at least 60% in the next 20 years) and an there is an accelerating contribution from both the ageing populations of industrialised countries and the rapid industrialisation of nations such as India and China. There are over seven million deaths per year from hypertension-related disease and many more debilitating events. Hypertension is responsible for about half of the 7.2 million fatal myocardial infarcts per year. It is the major cause of heart failure and chronic kidney disease and the primary risk factor for over 15 million strokes per year. This epidemic of vascular and renal disease threatens to overwhelm health services worldwide.3 The cost of treating hypertension and its complications in the US approaches US$60 billion per year.4
There are compelling data confirming that the treatment of these risk factors significantly reduces the incidence of related disease.5 Therapy of hypertension reduces the incidence of myocardial infarction by 20–25%, heart failure by more than 50% and stroke by 35–40%, and significantly retards the progression of chronic kidney disease to its end stage requiring dialysis or transplantation.6
Vascular and renal risk factors rarely exist in isolation. Improved outcomes require assessment of total cardiovascular risk and the targeting of these multiple risk factors, including lifestyle contributors.

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References
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