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Evidence From 58 Utah Families for a Syndrome Present in Approximately 12% of Patients With Essential Hypertension

Roger R. Williams, MD; Steven C. Hunt, PhD; Paul N. Hopkins, MD, MSPH; Barry M. Stults, MD; Lily L. Wu, PhD; Sandra J. Hasstedt, PhD; Gary K. Barlow, MS; Susan H. Stephenson, PharmD; Jean-Marc Lalouel, MD, Dsc; Hiroshi Kuida, MD

JAMA. 1988;259(24):3579-3586.

Abstract
Population-based sibships with essential hypertension diagnosed before the age of 60 years are being screened in Utah to find two or more hypertensive siblings with the same biochemical abnormality as a clue to an inherited cause for their specific type of hypertension. Among 131 hypertensive subjects in 58 sibships, concordant abnormalities in fasting serum lipid concentrations were observed in two or more siblings in 48% of the sibships. After adjusting for effects of antihypertensive medications, abnormal values reported in only 10% of the Lipid Research Clinics data were observed in 30% of patients for serum triglycerides, 19% for serum low-density lipoprotein cholesterol, and 39% for high-density lipoprotein cholesterol. More than one lipid level was abnormal in almost all concordant sibships, suggesting an association between hypertension and a syndrome of mixed lipid abnormalities, probably familial combined hyperlipidemia (renamed "familial combined dyslipidemia" because of common low high-density lipoprotein cholesterol levels). We conclude that familial dyslipidemic hypertension may be a specific syndrome with lipid abnormalities more severe than blood pressure elevations.

(JAMA 1988;259:3579-3586)

Author Affiliations
From the Departments of Medicine (Drs Williams, Hunt, Hopkins, Stults, Stephenson, and Kuida and Mr Barlow), Pathology (Dr Wu), and Human Genetics (Drs Hasstedt and Lalouel), University of Utah, Salt Lake City.

Footnotes
Reprint requests to Cardiovascular Genetics Research Clinic, 410 Chipeta Way, Room 161, Salt Lake City, UT 84108 (Dr Williams).

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