The Significance of Controlling Blood Pressure and Cholesterol for Cardiovascular Health

The importance of managing blood pressure and cholesterol

Hypertension family prevalence is 2.5 times higher
Lifestyle correction through early diagnosis
Prevention by lowering blood cholesterol

The number one cause of death worldwide is ischemic heart disease, such as angina and myocardial infarction, and the second is stroke. This means that most deaths are due to diseases that occur in the heart or cerebrovascular system. Ischemic heart disease affects about 9 million people worldwide each year, and a stroke occurs in one person every two seconds and kills one person every six seconds.
Cardiovascular disease risk factors include: ▶ high blood pressure ▶ dyslipidemia in men aged 45 years or older or women aged 55 years or older ▶ family history of vascular disease among parents or siblings. The US Centers for Disease Control and Prevention (CDC) also recommends that “a family history is the first step in preventing cardiovascular disease, and you must tell your doctor about your family history.” Family history refers to the case of two or more patients who have suffered from the same disease within three generations of immediate family or cousins. Unlike heredity, which inherits specific genetic information, family history has a complex effect on heredity, lifestyle, and environment. In other words, family history is a clue to reduce and prevent the risk of onset through early diagnosis or lifestyle correction.

A US research team analyzed the risk of developing cardiovascular disease according to the presence or absence of a family history in 6,200 people over 10 years. The research team consisted of a group of parents, siblings, and siblings with a history of coronary artery disease (CHD), angina pectoris, stroke, peripheral arterial disease, congestive heart failure, etc. The incidence rate was analyzed by dividing into groups with a family history of early-onset cardiovascular disease. 36% of all participants had a family history of cardiovascular disease, and 16% had a family history of early onset. People with a family history of cardiovascular disease had a 37% higher risk of coronary artery disease, 60% higher risk of angina pectoris, and 28% higher risk of atherosclerotic cardiovascular disease than those without a family history. In addition, if there was a family history of early onset of cardiovascular disease, the risk of coronary artery disease, angina pectoris, and atherosclerotic cardiovascular disease was 33%, 58%, and 29% higher, respectively.

Hypertension is the strongest risk factor for coronary artery disease, angina pectoris, and myocardial infarction, which are representative family diseases. When blood vessels are continuously damaged by high blood pressure and cholesterol, calcium, and waste products accumulate in that area, the blood vessels become narrowed and blocked. In fact, in a study of about 290,000 Koreans, it was found that the risk of cardiovascular disease increased by about two times when the systolic blood pressure increased by 20 mmHg. Hypertension is also a key risk factor for stroke. As a result of analyzing the stroke attributable risk (PAR) by age group, the most important risk factor for stroke in middle age (55 to 74 years old) was hypertension, with an attributable risk of 31%. 67 out of 100 stroke patients suffered from hypertension.

Hypertension, a leading disease of cardiovascular disease, is also a representative family disease. A research team led by Professor Jung-Sik Son of Seoul National University Hospital analyzed 8,280 adults who participated in the National Health and Nutrition Examination Survey from 2014 to 2016. 43.8% of all participants had a family history of hypertension, and their actual prevalence of hypertension was 25.4%. This means that 1 in 4 people with a family history of high blood pressure will develop high blood pressure. In particular, in a study targeting Korean adolescents, it was confirmed that cardiovascular diseases, including hypertension, can be inherited.

In addition, as a result of analyzing the data of 554 adolescents aged 13 to 19 who participated in the 2013 National Health and Nutrition Examination Survey, the risk of hypertension in their children was 3.05 times higher if their parents had hypertension. In 16.2% of the subjects, a parental history of hypertension was confirmed, and their risk of cardiovascular disease increased by 2.08 times for overweight, 2.11 times for obesity, 2.36 times for abdominal obesity, and 2.86 times for liver dysfunction such as fatty liver.

Cholesterol is a component of cell membranes and plays an important role in making hormones, but it is also the main culprit in high blood pressure and cardiovascular disease. When LDL cholesterol in the blood is excessively high, LDL cholesterol particles enter the inner lining of blood vessels and are easily oxidized, triggering an inflammatory response. As the inflammatory response continues, the fat mass gradually grows, and calcium and other substances accumulate around the enlarged mass and harden. The heart pumps blood to a higher pressure to send blood throughout the body through these hard and narrowed blood vessels, raising blood pressure. Moreover, high blood pressure, together with high blood sugar, acts as a cause of oxidizing LDL, accelerating the progression of arteriosclerosis.

Therefore, the lower the blood cholesterol level, the lower the risk of hypertension. A Japanese medical university research team divided 14,215 middle-aged men with normal blood pressure into 5 groups according to cholesterol levels and compared the incidence of hypertension over a 4-year period. The incidence was 28% lower than that of the group with the highest total cholesterol level (222-369 mg/dL). Additionally, the group with the lowest LDL cholesterol had a 27% lower incidence of hypertension than the group with the highest. Through this thesis, the research team analyzed that blood pressure gradually increases due to cholesterol increase, which can increase the risk of cardiovascular disease.

Janghoon Ryu ([email protected])