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Joseph V. Selby, MD; Beth Newman, PhD; Jose Quiroga, MD; Joe C. Christian, MD, PhD; Melissa A. Austin, PhD; Richard R. Fabsitz, MA

JAMA. 1991;265(16):2079-2084.

Abstract
Sixty cases of dyslipidemic hypertension were identified in the 1028 middleaged, white, male twin participants in the first examination of the National Heart, Lung, and Blood Institute Twin Study (1969 to 1973). The prevalence of dyslipidemic hypertension was similar by zygosity but proband concordance was three times greater in monozygotic than dizygotic twins (0.44 [seven concordant and 18 discordant pairs] vs 0.14 [two concordant and 24 discordant pairs]), suggesting a genetic effect on the condition. Low high-density lipoprotein cholesterol level was the most common lipid abnormality in concordant pairs. Mortality from ischemic heart disease was significantly higher in individuals with dyslipidemic hypertension. Obesity and glucose intolerance were closely associated with the syndrome. Moreover, within the 18 discordant monozygotic twin pairs, the twins with dyslipidemic hypertension had gained significantly more weight as adults and were significantly heavier than their unaffected cotwins. Thus, although genetic factors may influence development of dyslipidemic hypertension, nongenetic, potentially modifiable aspects of obesity are also closely related to expression of this clinically important syndrome.

(JAMA. 1991;265:2079-2084)

Author Affiliations
From the Division of Research, Kaiser Permanente Medical Care Program, Northern California Region, Oakland (Drs Selby and Newman); the Department of Epidemiology, School of Public Health, University of California, Berkeley (Dr Newman); the Department of Medicine, Veterans Affairs Medical Center, Long Beach, Calif (Dr Quiroga); the Department of Medical Genetics, Indiana University School of Medicine, Indianapolis (Dr Christian); the Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle (Dr Austin); and the Clinical and Genetic Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, Md (Mr Fabsitz). Dr Newman is now with the Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill.

Footnotes
Reprint requests to Division of Research, Kaiser Permanente, 3451 Piedmont Ave, Oakland, CA 94611 (Dr Selby).

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