P248	Dyslipidemic hypertension: features and cardiovascular risk in a prospective population-based study.
1A.Onat, 2G.Hergenc, 3I.Sarý, 4S.Turkmen, 5G.Can, 5V.Sansoy
1Turkish Soc Cardiology, Istanbul, TR; 2Yildiz T Univ Biol Dept, Istanbul, TR; 3Siyami Ersek Cardiovasc Surg, Istanbul, TR; 4Gaziantep Med Fac Cardiol Dept, Gaziantep, TR; 5Cerrahpasa Med Fac, Istanbul, TR.

Background: The prevalence, features and risk for cardiovascular disease (CVD) of dyslipidemic hypertension (DH) was investigated in a prospective population-based study. DH was defined in terms of blood pressure, plasma triglyceride and HDL-cholesterol consistent with the metabolic syndrome (MS) criteria of the NCEP guidelines. High-normal or hypertensive values not meeting the other two criteria were designated as “simple hypertensives” (SH). Methods: A sample of 2225 men and women and free of CVD at baseline were followed up for a mean of 4.1 years. The proportions of DH, SH and normotensives were 16%, 37% and 47%, respectively. All persons with DH had MS by definition, while MS formed 44.6% of SH. Fatal and nonfatal CVD, diagnosed by clinical findings and Minnesota coding of resting electrocardiograms, developed in 166 subjects. Results: Compared to SH, individuals with DH had significantly higher nonHDL-cholesterol, TC/HDL-C ratio, fasting insulin and glucose levels, had higher prevalence of impaired fasting glucose and MS. Though SH exhibited twice the relative risk (RR) for CVD as normotensives, DH carried higher sex- and age-adjusted RR for CVD (1,67 [CI 1.13; 2.47]) than SH. Excess RR in DH largely persisted after adjustment for LDL-cholesterol and smoking status. Among persons with DH, age, presence of diabetes, pulse pressure and current smoking proved to be independent predictors for CVD. High LDL-C levels and fasting hyperinsulinemia were associated with borderline-significantly elevated RRs among dyslipidemic hypertensives Conclusion: DH, prevailing in 1 of every 6 adults, implicates characteristic features, confers excess CVD risk compared to the remainder of hypertensives and carries half the attributable risk due to MS.

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