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Latest findings from the Physicians’ Health Study

High Cholesterol May Lead to High Blood Pressure in Men
Men with elevated levels of “bad” cholesterol may increase their risk of hypertension by 39 percent, “good” cholesterol appears to protect against high blood pressure

Boston — Hypertension affects more than 50 million Americans each year and is an important risk factor for cardiovascular disease. Researchers at Brigham and Women’s Hospital (BWH) have found that there may be a link between high cholesterol levels and the development of hypertension in men. These findings will be published in an online edition of Hypertension: Journal of the American Heart Association on December 13, 2005 and in the January 1, 2006 print edition. 

“There appears to be a significant association between increased cholesterol levels and the risk of developing hypertension in healthy, middle aged men,” says author, Howard Sesso, ScD, MPH, an epidemiologist in the Department of Preventive Medicine at Brigham and Women’s Hospital. “Our findings suggest we may have a new means of preventing hypertension, a devastating public heath issue in this country. If we can encourage men to improve their cholesterol levels, we may reduce their risk of developing high blood pressure later in life.” 

In this study, researchers prospectively examined data from more than 3,000 participants in the Physicians’ Health Study who were free of hypertension, cardiovascular disease and cancer. Participants submitted baseline blood samples at the start of the study and responded to follow-up questionnaires at six months and then annually thereafter reporting the incidence of hypertension, other conditions, and health habits. Over an average of 14 years of follow up, approximately one third of the men developed hypertension. 

Researchers divided the participants who developed hypertension into five categories from those with the lowest total cholesterol levels to those with the highest. They also examined total cholesterol, high-density lipoprotein (HDL) or “good” cholesterol, non-HDL cholesterol (calculated by subtracting HDL cholesterol from total cholesterol) and the ratio between total cholesterol and HDL cholesterol. 

The researchers found that elevated levels of total cholesterol, non-HDL cholesterol and the total cholesterol to HDL ratio were individually associated with an increased risk of hypertension. Additionally, the study indicated that higher levels of “good” cholesterol appear to be associated with a decreased risk of hypertension. 
Specifically, they report:

• Men with the greatest total cholesterol to HDL cholesterol ratio were at a 54 percent increased risk for hypertension compared to the men with the lowest ratio.
• Men with the highest levels of non-HDL cholesterol were 39 percent more likely to develop hypertension than those with the lowest levels of non- HDL cholesterol.
• Men with the highest levels of total cholesterol were 23 percent more likely to develop hypertension than men with the lowest levels.
• Men with the highest HDL levels had a 32 percent lower risk of developing hypertension than those with the lowest HDL levels. 

“By identifying new risk factors for hypertension that may be amenable to intervention, such as improving cholesterol levels, we may eventually be able to reduce the burden of hypertension and subsequent cardiovascular disease," said Sesso, who is also an assistant professor of Medicine at Harvard Medical School.

Researchers note that further investigation is needed to determine if lipids have an independent association with the development of hypertension. 
 
Please contact BWH Media Relations for more information at (617) 534-1600 or BWHMediaRelations@partners.org

Brigham and Women's Hospital is a 747-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare System, an integrated health care delivery network. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery.  The BWH medical preeminence dates back to 1832 and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives, dedication to educating and training health care professionals, and strength in biomedical research. With $370M in funding and more than 500 research scientists, BWH is an acclaimed leader in clinical, basic and epidemiological investigation - including the landmark Nurses Health Study, Physicians Health Studies, and the Women's Health Initiative.  For more information about BWH, please visit: www.brighamandwomens.org.