Hypertension and Hyperlipidemia: Dual Risks and Prevention of Arteriosclerosis

Hypertension combined with hyperlipidemia: Human blood contains many lipids, among which cholesterol, triglycerides, phospholipids, and free fatty acids are closely related to atherosclerosis, coronary heart disease, and hypertension. Lipids are insoluble in water and must bind with different apolipoproteins to form hydrophilic lipoproteins before they can be excreted from the body. Apolipoproteins are classified into three types according to molecular size and density: high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL). Hyperlipidemia refers to a condition where the level of blood lipids or lipoproteins consistently exceeds the normal range.

In hypertension combined with hyperlipidemia, due to damage to the vascular endothelium, blood lipids easily enter the arterial media, leading to atherosclerosis. Statistics show that hypertensive patients have a significantly higher chance of developing atherosclerotic heart disease than normal individuals and those with low blood pressure. Animal experiments have also demonstrated that when animals fed cholesterol are simultaneously injected with norepinephrine to raise their blood pressure, the rate of atherosclerosis in these animals is faster and the lesions are more extensive than in animals fed only cholesterol.

The reasons for this may include the increased permeability of the large artery intima to plasma lipoproteins due to persistent high arterial pressure, and the presence of lipid metabolism disorders associated with hypertension. On the other hand, the development of atherosclerosis can also accelerate the progression of hypertension. For example, in simple arteriosclerosis, especially aortic sclerosis, reduced vascular elasticity prevents the same amount of blood from being delivered throughout the body. This necessitates increased cardiac contractility to complete the task, thus raising systolic blood pressure. Similarly, renal artery sclerosis affecting renal blood flow can also cause or worsen hypertension. When renal artery lesions are corrected surgically or the diseased kidney is removed, hypertension often returns to normal or near-normal levels.

In a sense, elevated blood lipids act as a causal link between persistent hypertension and atherosclerosis. Therefore, patients with hypertension and hyperlipidemia should be given sufficient attention, and treatment should focus on lowering blood lipids and improving lipid metabolism while treating hypertension.