Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1991 April; 84(4): 203–205.
PMCID: PMC1293182

Management choices for hypertension with coexistent hypercholesterolaemia.


Guidelines for the management of either hypertension or hyperlipidaemia have been widely published. However, recent data have shown the high frequency of an abnormal lipid profile in hypertensive subjects. We have therefore surveyed 195 general practitioners throughout Britain to determine current community-based attitudes and management approaches to hypertension with coexistent hypercholesterolaemia. Routine screening for lipids in hypertensive subjects was recommended by 40% of respondents. First-line antihypertensive drug choices were influenced by the knowledge of a hypercholesterolaemia, with preference for drugs known to have no adverse effects on the lipid profile. When first-choice drug failed to effectively lower blood pressure, the additional drug or the substitute choices were not influenced by the metabolic profiles of the alternative selected. The current wide choice of antihypertensive drugs and the complexity of metabolic complications of treatment plus the relationship of risk factor clustering has made the formulation of management strategies very difficult. This was supported by the finding that 88% of respondents in our survey felt that there was a clear need for consensus management guidelines for the treatment of hypertension with coexistent hypercholesterolaemia.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (660K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Hart JT. The management of high blood pressure in general practice. J R Coll Gen Pract. 1975 Mar;25(152):160–192. [PMC free article] [PubMed]
  • Shepherd J, Betteridge DJ, Durrington P, Laker M, Lewis B, Mann J, Miller JP, Reckless JP, Thompson GR. Strategies for reducing coronary heart disease and desirable limits for blood lipid concentrations: guidelines of the British Hyperlipidaemia Association. Br Med J (Clin Res Ed) 1987 Nov 14;295(6608):1245–1246. [PMC free article] [PubMed]
  • Castelli WP, Anderson K. A population at risk. Prevalence of high cholesterol levels in hypertensive patients in the Framingham Study. Am J Med. 1986 Feb 14;80(2A):23–32. [PubMed]
  • MacMahon SW, Macdonald GJ. Antihypertensive treatment and plasma lipoprotein levels. The associations in data from a population study. Am J Med. 1986 Feb 14;80(2A):40–47. [PubMed]
  • Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988 Dec;37(12):1595–1607. [PubMed]
  • Weidmann P, Ferrier C, Saxenhofer H, Uehlinger DE, Trost BN. Serum lipoproteins during treatment with antihypertensive drugs. Drugs. 1988;35 (Suppl 6):118–134. [PubMed]
  • Feher MD, Betteridge DJ. Lipids, lipoproteins, and coronary heart disease: implications for antihypertensive therapy. Cardiovasc Drugs Ther. 1989 Jun;3 (Suppl 1):333–340. [PubMed]
  • Stamler J, Wentworth D, Neaton JD. Prevalence and prognostic significance of hypercholesterolemia in men with hypertension. Prospective data on the primary screenees of the Multiple Risk Factor Intervention Trial. Am J Med. 1986 Feb 14;80(2A):33–39. [PubMed]
  • Kannel WB. Hypertension. Relationship with other risk factors. Drugs. 1986;31 (Suppl 1):1–11. [PubMed]
  • MacMahon SW, Cutler JA, Furberg CD, Payne GH. The effects of drug treatment for hypertension on morbidity and mortality from cardiovascular disease: a review of randomized controlled trials. Prog Cardiovasc Dis. 1986 Nov-Dec;29(3 Suppl 1):99–118. [PubMed]
  • Dittrich H, Gilpin E, Nicod P, Cali G, Henning H, Ross J., Jr Acute myocardial infarction in women: influence of gender on mortality and prognostic variables. Am J Cardiol. 1988 Jul 1;62(1):1–7. [PubMed]
  • Shaper AG, Pocock SJ, Walker M, Cohen NM, Wale CJ, Thomson AG. British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. Br Med J (Clin Res Ed) 1981 Jul 18;283(6285):179–186. [PMC free article] [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press