Cholesterol control and incident antihypertensive treatment in hypercholesterolemic subjects treated or not with statins: a pharmacoepidemiological report

Purpose: The aim of our study was to evaluate the association between low-density lipoprotein cholesterol (LDL-C) level, statin treatment and the incidence of new antihypertensive treatment in a large population sample. Methods: A population-based cohort of 23,849 subjects from two Italian Local Health Units (LHU) aged 18 years or older with at least one LDL-C measurement and free of antihypertensive treatment at baseline was followed from the LDL-C date until death or December 31, 2009. The cohort was subdivided into two groups (LDL-C Results: During the mean follow-up of 1.3 years, 10.4% (n=1,382) of patients with LDL-C < target and 13.6% (n=1,442) of patients with LDL-C &#8805; target started antihypertensive treatment. Compared with the LDL-C < target group, the LDL-C &#8805; target group showed a higher overall incidence rate (7.59 vs 10.78 per 100 person-years, P&lt;0.001). In the multivariable Cox regression analysis, after adjustments for the potential confounding variables, compared with LDL-C &#8805; target group, the hazard ratio (HR) of AHT treatment was reduced among those with LDL-C < target (HR=0.91; 95%CI: 0.84-0.98). Significant HRs were also observed for age – increasing age increases the risk of new cases of AHT treatment than the age group below 45 years –, diabetes (HR=1.32; 95%CI: 1.16-1.49) and previous CV disease (HR=0.35; 95%CI: 0.20-0.63). Gender, CV diseases and statin treatment per se were not found significant predictors of the incidence of antihypertensive treatment. Conclusion: A better control of serum cholesterol levels seems to be associated to a significantly lower incidence of new antihypertensive treatment in a large cohort of general population.