Current views on treatment of dyslipidemia assosiated with arterial hypertension (review)

Currently, alimentary associated dyslipidemia and hypertension are considered to be the major independent risk factors for cardiovascular disease. Their effective treatment leads to a significant decrease in cardiovascular diseases and mortality. Many physicians underestimate the benefits of drug-free modalities in treatment of dyslipidemia associated with arterial hypertension, namely, well-balanced diet and graduated exercise, especially on the background of constant drug therapy. The main aim of this paper is to highlight the results of current trial on treatment of dyslipidemia associated with arterial hypertension. In literature there exists such a viewpoint that effective blood pressure decrease and dyslipidemia resolution are the main methods of atherosclerosis treatment and prevention. At the same time it is not always possible to achieve target variables of these indices. Consequently, simultaneous lipid-lowering and antihypertensive therapy demands much attention. Such therapy is possible in the majority of patients with different levels of cardiovascular risk. The paper highlights the main aspects of complex treatment of dyslipidemia and arterial hypertension according to the level of cardiovascular risk. The author considers in detail the latest views on pathogenetic links between dyslipidemia and arterial hypertension. The role of hypercholesterolemia as a factor lowering the bioavailability of nitric oxide is also examined. It increases the rigidity of vascular walls, sensitivity of smooth muscle cells to sodium and intensifies general mechanisms of calcium channels. However, high blood pressure increases the rate of penetration of atherogenic lipoproteins into vascular walls by means of pressory convection. Thus, lipoprotein particles penetrate into mechanically stretched due to high blood pressure subendothelial structures. The author also summarizes information obtained from various clinical trials on evaluation of curative options of combined administration of statins and antihypertensive drugs in patients with dyslipidemia and arterial hypertension. The paper gives data on the results of administration of fixed-dose combinations taking into account patients' compliance rate to long-term therapy.