Endocrine Abstracts

Background: Early diagnosis and treatment of high blood pressure (BP) and high cholesterol is important to reduce cardiovascular mortality risk.

Methods: We assessed actual BP and LDL-cholesterol (LDL-C) levels in 88,029 participants (36,122 men), aged 18-80 yrs, without diabetes, from the Dutch Lifelines Cohort study. Participants were categorized according to degree of obesity (normal weight, overweight, obese) and age decade group. BP measurement was rigorously standardized. Mean systolic and diastolic BP were calculated depending on BP-treatment status for the three BMI classes, and for each age group. We repeated these evaluations for LDL-C levels.

Results: In total, 13.3% of men and 15.6% of women were obese. BP increased gradually in each age group, with mean levels of 124/68 mmHg in the youngest and 142/77 mmHg in the oldest male participants, and was significantly higher in obese vs. non-obese and overweight individuals in all age groups (P<0.01). The largest difference (10-11 mmHg) between obese and non-obese was observed in males below 50 yrs. Despite the use of BP-lowering medication (5.1–6.2% in non-obese, 21% in obese), still 20–50% had elevated systolic BP≥140 mmHg. Overall mean LDL-C was 3.5±0.9 mmol/l in obese vs. 3.2±0.9 mmol/l in non-obese men (P<0.001), and 3.3±0.9 vs 2.9±0.8 mmol/l in women (P<0.001). More untreated obese than non-obese participants had an LDL-C ≥3.5 mmol/l (men: 56% vs 37%, women: 41% vs 24%, both P<0.001). Only 37% of obese men and 28% of obese women treated with statins reached an LDL-C target <2.5 mmol/l. A small percentage of obese individuals treated with BP-lowering drugs also were using statins (33% in men, 16% in women).

Conclusions: Obese individuals have higher BP and LDL-C compared to non-obese, and especially obese men younger than 50 yrs have elevated BP levels. There is considerable undertreatment of elevated BP and elevated LDL-C in the general population.