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The association between blood pressure and lipid levels in Europe: European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice

Borghi, Claudio; Rodriguez-Artalejo, Fernando; De Backer, Guy; Dallongeville, Jean; Medina, Jesús; Guallar, Eliseo; Perk, Joep; Banegas, José R.; Tubach, Florence; Roy, Carine; Halcox, Julian P.

doi: 10.1097/HJH.0000000000001078

Objectives: Several studies have suggested a positive association between serum lipid levels and blood pressure (BP). This study investigated this association in a large population from 12 European countries.

Methods: Data were taken from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice ( identifier: NCT00882336). Associations between BP and lipid levels in patients free from cardiovascular disease and with at least one major cardiovascular disease risk factor (N = 7641) were assessed using linear regression analyses.

Results: Overall, 72.8 and 64.8% of patients had hypertension and dyslipidaemia, respectively; 47.0% had both conditions. Regression coefficients (95% confidence interval) for the associations of LDL cholesterol, non-HDL cholesterol, total cholesterol and apolipoprotein B levels with SBP, adjusted for age, sex and BMI, were 0.93 mmHg/mmol per l (0.54–1.31), 1.07 mmHg/mmol per l (0.73–1.40), 1.02 mmHg/mmol per l (0.69–1.35) and 4.94 mmHg/g per l (3.43–6.46), respectively. The corresponding values (95% confidence interval) for the associations with DBP were 0.96 mmHg/mmol per l (0.73–1.19), 0.95 mmHg/mmol per l (0.75–1.15), 0.87 mmHg/mmol per l (0.67–1.07) and 4.33 mmHg/g per l (3.42–5.23), respectively. Most of these associations remained significant whether patients were treated with statins or not.

Conclusion: Small but statistically significant associations between lipid levels and BP were observed in a large, multinational European population. Further research is warranted to assess the causality of this association and its implications on the management of patients with both hypertension and dyslipidaemia.

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aDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy

bDepartment of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz

cCIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain

dDepartment of Public Health, Ghent University, Ghent, Belgium

eINSERM U 744, Institut Pasteur de Lille, Université Lille-Nord de France, Lille, France

fMedical Evidence and Observational Research, Global Medical Affairs, AstraZeneca Farmacéutica Spain, Madrid, Spain

gDepartments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

hSchool of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden

iDépartement d’Épidémiologie et Recherche Clinique, Assistance Publique – Hôpitaux de Paris, Hôpital Bichat


kDépartement d’Épidémiologie et Recherche Clinique, Centre de pharmacoépidémiologie (Cephepi), Assistance Publique – Hôpitaux de Paris, Hôpital Bichat

lUniversité Paris Diderot, Sorbonne Paris Cité, ECEVE, UMR 1123, Paris, France

mSwansea University School of Medicine, Swansea, UK

Correspondence to Professor Claudio Borghi, Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Via Albertoni 15 – Pad. 2, 40138 Bologna, Italy. Tel: +39 0512142843; fax: +39 051391320; e-mail:

Abbreviations: ACE, angiotensin-converting enzyme; apo-A1, apolipoprotein A1; apo-B, apolipoprotein B; AT1, angiotensin II type 1; BP, blood pressure; CHD, coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; EURIKA, European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice; HDL-C, HDL cholesterol; LDL-C, LDL cholesterol

Received 3 March, 2016

Revised 26 May, 2016

Accepted 13 July, 2016

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