VBWG Synergistic actions of hypertension and dyslipidemia on endothelial function Implications for treatment Mason RP et al. Circulation. 2004;109(suppl II):II Mason RP et al. ATVB. 2003;23: Statins Antihypertensives Dyslipidemia Hypertension Synergistic loss in endothelial function Synergistic increase in endothelial function

VBWG High prevalence of multiple CV risk factors in hypertensive adults Percentages are weighted to state population estimates and age adjusted to the 2000 US standard population using 4 age groups Greenlund KJ et al. Arch Intern Med. 2004;164: High cholesterol level DiabetesObesitySmoking≥1 other CV risk factors US adults ≥18 yrs with additional risk factors (%) Behavioral Risk Factor Surveillance System, 1999

VBWG Prevalence of hypertension and dyslipidemia increases with age Kaiser Permanente Medical Care Program, Northern California, 2001 Selby JV et al. Am J Manag Care. 2004;10(2 part 2): Prevalence (%) HypertensionDyslipidemiaBoth Women Men 20–44 55–64 ≥ –44 45–54 55–64 ≥65 45–54 Age (yrs)

VBWG Dyslipidemia in hypertensive adults: High prevalence, insufficient treatment Genetic Epidemiology Network of Arteriopathy (GENOA) study O’Meara JG et al. Arch Intern Med. 2004;164: WomenMen African American (n = 1286) PrevalenceTreatmentControl WomenMen White (n = 1070) 25.5 Hypertensive subjects (%)

VBWG Number of antihypertensive agents needed to achieve systolic BP control Bakris et al. Am J Kidney Dis. 2000;36: ALLHAT. JAMA. 2002;288: Berl et al. Ann Intern Med. 2003;138: Bakris et al. Arch Inten Med. 2003;163: Wright et al. JAMA. 2002;288: Pepine et al. JAMA. 2003;2980: *~50% patients required ≥3 † Average per patient 4321 Number of BP medications † Trial SBP achieved (mm Hg) ALLHAT138 IDNT138 RENAAL141 UKPDS144 ABCD132 MDRD132 HOT138 AASK128 INVEST131 *

VBWG Gemini: LDL-C and BP goal achievement by multiple-risk patients NCEP ATP III. JAMA. 2001;285: JNC VI. Arch Int Med. 1997;157: Blank R et al. J Am Coll Cardiol. 2004;43(suppl A):447A LDL-C goal (NCEP ATP III) BP goal (JNC VI) Both LDL-C and BP goals Patients at goal (%) N = 1220