Selby J V, Newman B, Quiroga J, Christian J C, Austin M A, Fabsitz R R
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94611.
JAMA. 1991 Apr 24;265(16):2079-84.
Sixty cases of dyslipidemic hypertension were identified in the 1028 middle-aged, 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.
在美国国立心肺血液研究所双胞胎研究（1969年至1973年）首次检查的1028名中年白人男性双胞胎参与者中，确诊了60例血脂异常性高血压患者。血脂异常性高血压的患病率在同卵双胞胎和异卵双胞胎中相似，但先证者的一致性在同卵双胞胎中是异卵双胞胎的三倍（0.44 [7对一致和18对不一致] 对比0.14 [2对一致和24对不一致]），提示该病存在遗传效应。高密度脂蛋白胆固醇水平低是一致对中最常见的血脂异常。血脂异常性高血压患者的缺血性心脏病死亡率显著更高。肥胖和葡萄糖耐量异常与该综合征密切相关。此外，在18对不一致的同卵双胞胎中，患有血脂异常性高血压的双胞胎成年后体重增加显著更多，且比未受影响的同胞双胞胎明显更重。因此，虽然遗传因素可能影响血脂异常性高血压的发生，但肥胖的非遗传、潜在可改变方面也与这一具有临床重要性的综合征的表现密切相关。
