The definition of "three highs" and their intertwined dangerous relationships

The "three highs" refer to hypertension, diabetes, and hyperlipidemia. These three conditions can exist independently or influence each other and coexist. The relationship between them is as follows.

Hyperlipidemia and Hypertension: Hyperlipidemia is a major factor in the formation and development of atherosclerosis, and atherosclerosis is closely related to hypertension. Numerous studies have shown that many hypertensive patients also have lipid metabolism disorders, with significantly elevated levels of cholesterol and triglycerides in their blood, while their high-density lipoprotein and cholesterol levels are lower. On the other hand, many patients with hyperlipidemia also frequently have hypertension, suggesting a causal relationship, although the exact cause and effect are currently unclear. Simultaneously, both hypertension and hyperlipidemia are important risk factors for coronary heart disease, thus demonstrating the correlation among the three. In my country, over 70% of coronary heart disease patients also have hypertension.

High blood sugar and high blood pressure: Diabetes and high blood pressure are closely related. Survey data in my country show that the blood pressure levels of diabetic patients are higher than those of non-diabetic individuals. The prevalence of hypertension in diabetic patients is significantly higher than in non-diabetic individuals, generally 1.5 to 2 times higher than in the general population. International statistics show that the prevalence of hypertension among diabetic patients can be as high as 40% to 80%. Furthermore, the vast majority of diabetic patients also have hypertriglyceridemia (TG) or mixed hyperlipidemia in the pre-diabetic and early stages of the disease, which is essentially related to overweight and obesity.

Hyperlipidemia and Hyperglycemia: Dyslipidemia can worsen diabetes and increase the risk of stroke, coronary heart disease, limb necrosis, retinopathy, nephropathy, and neuropathy. These long-term complications are major causes of disability or premature death in diabetic patients. In general, diabetes, hyperlipidemia, hypertension, and obesity can all lead to atherosclerosis. Their combined effect accelerates the progression of atherosclerosis. Studies have shown that the risk of coronary heart disease is six times higher in individuals with any two of these four risk factors combined. If three or four risk factors are combined, the risk can be as high as 36 times higher. In recent years, with economic development and improved living standards, the incidence of hypertension, diabetes, and hyperlipidemia (commonly known as the "three highs") has been rising annually. A national epidemiological survey in 2002 showed that my country had 160 million people with hypertension, 160 million with dyslipidemia, over 20 million with diabetes, 200 million overweight people, 60 million obese people, and 350 million smokers. Diabetes is characterized by its insidious nature, stubbornness, complexity, specificity, and variability. It can lead to systemic multi-organ complications, affecting the heart, brain, kidneys, eyes, and feet, making treatment extremely difficult. In developed countries, the prevalence of diabetes is as high as 5%–10%. In my country, the number of people with diabetes is increasing rapidly at an alarming rate. Currently, there are nearly 40 million people with type 2 diabetes in my country, with at least 1.2 million new cases added annually, or at least 3,000 new cases daily. Diabetes not only brings suffering to patients but also places a huge burden on families and society. High blood lipids have long been considered a "silent killer" by the medical community because they often lack obvious symptoms or discomfort, making them difficult for patients to detect. However, they are a major cause of ischemic cardiovascular diseases such as coronary heart disease and cerebral thrombosis, potentially leading to disability or death. The public's awareness of dyslipidemia in my country is far from sufficient; many people are unaware of its harmful effects, and a large number of people with dyslipidemia go undiagnosed. Most diagnosed patients do not have ideally controlled blood lipid levels. Hypertension has become the leading cause of death in my country. Hypertension is not only an independent chronic disease but also a significant risk factor for stroke, myocardial infarction, heart failure, and chronic kidney disease. According to the 2006 China Cardiovascular Disease Report, 10 million new hypertension patients are diagnosed in China each year, with an estimated 200 million people suffering from hypertension in 2006-meaning one in five adults has hypertension. The current state of hypertension prevention and treatment in my country is characterized by "three highs" and "three lows": high incidence, high disability rate, high mortality rate, and low awareness (30.2%), low treatment rate (24.7%), and low control rate (6.1%). It is also important to note that hypertension, hyperlipidemia, and hyperglycemia can influence each other and coexist. Dyslipidemia can worsen diabetes and hypertension, making stroke and coronary heart disease more likely; diabetes can cause hypertension through various mechanisms, and the prevalence of hypertension in diabetic patients is generally 1.5 to 2 times higher than in the general population; hypertension patients often have lipid metabolism disorders, and both hypertension and hyperlipidemia are important risk factors for coronary heart disease. Metabolic syndrome, also known as insulin resistance syndrome, refers to the coexistence of multiple diseases such as hypertension, hyperglycemia, hyperlipidemia, and obesity. It is a complex metabolic disorder involving various metabolic abnormalities, with prominent manifestations including overweight, obesity, hypertension, and arteriosclerosis. The common pathogenesis is insulin resistance, which can directly lead to serious cardiovascular diseases and severely endanger people's health. The prevention and treatment of diabetes is a comprehensive and systematic project, encompassing health education for diabetic patients, drug therapy, dietary therapy, exercise therapy, and blood glucose monitoring. The core treatment for hypertension is lowering blood pressure. Antihypertensive drug therapy can effectively reduce the incidence and mortality of cardiovascular diseases and prevent the occurrence and development of stroke, coronary heart disease, heart failure, and kidney disease. This should be combined with lifestyle changes such as diet and exercise. Dietary therapy and lifestyle modifications are fundamental measures for the treatment of dyslipidemia. Every patient with the "three highs" (hypertension, hyperglycemia, and hyperlipidemia) should recognize the dangers of these conditions, master standardized treatment methods, understand the importance of lifestyle changes, and master the principles and methods of lifestyle modification.