Mantari M, Tiula E, Alikoski T, Manninen V
Effects of hypertension and dyslipidemia on the decline in renal function

Hypertension (Oct) 26:670-675 1995

This paper studies the effects of elevated total (non-HDL) cholesterol levels on the progression of chronic renal insufficiency in 2702 patients (those with complete serial creatinine collections) forming a subgroup of the Helsinki Heart Study. All patients in the trial were hyperlipidemic and were randomly allocated to treatment with either gemfibrozil or placebo. 302 were taking anti-hypertensive medications and 66 had type II DM. Over a 4-5 year follow-up there was a 5% increase in serum creatinine in both placebo and gemfibrozil groups. Because follow-up was relatively short, and because patients initially had normal renal function, the overall decline in renal function was small. However, diastolic BP > 95 mm Hg was associated with a higher increase in SCr. An LDL/HDL ratio of > 4.4 was not associated with an accelerated increase in SCr in normotensive subjects, but did increase the SCr rise in hypertensive subjects.

Comment: The study is difficult to interpret, as only SCr was measured, and the overall change in SCr was small. Nevertheless, the data do suggest a potential interaction of hyperlipidemia with hypertension in accelerating the "age- related" decline in renal function. (Daugirdas)

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