Introduction on Antiplatelet and Lipid-lowering Drugs in Hypertension
Hypertension is the most prevalent cardiovascular disease affecting 20–50 % of the adult population.1 Elevated blood pressure has been identified as a risk factor for coronary heart disease (CHD), heart failure, stroke, peripheral arterial disease, renal failure and atrial fibrillation both in men and women in a large number of epidemiological studies.2–4 So far, the largest meta-analysis of randomised trials of blood pressure reduction has shown that lowering systolic blood pressure by 10 mmHg and diastolic blood pressure by 5 mmHg using any of the main classes of blood pressure-lowering drugs reduces CHD events and heart failure by about a quarter, and stroke by about a third.5 The benefit of antihypertensive medication is due mostly to blood pressure lowering per se.
Hypertension often clusters with other cardiovascular (CV) risk factors associated with increased risk of CV events. Hypertension and dyslipidaemia are two major CV risk factors highly prevalent either alone or in combination.6 Due to interaction of CV risk factors, the probability of a CV event is frequently greater in patients with only moderate blood pressure and cholesterol abnormalities in the presence of additional risk factors.
A major aim of treating hypertension is a maximal decrease of long-term total CV risk, which could only be achieved by treatment of all reversible risk factors and associated conditions in addition to treatment of raised blood pressure per se.
The aim of this review is to analyse whether there is further benefit from antiplatelet and lipid-lowering drugs in hypertension.