Williams R R, Hunt S C, Hopkins P N, Stults B M, Wu L L, Hasstedt S J, Barlow G K, Stephenson S H, Lalouel J M, Kuida H
Department of Medicine, University of Utah, Salt Lake City.
JAMA. 1988 Jun 24;259(24):3579-86. doi: 10.1001/jama.259.24.3579.
Population-based sibships with essential hypertension diagnosed before the age of 60 years are being screened in Utah to find two or more hypertensive siblings with the same biochemical abnormality as a clue to an inherited cause for their specific type of hypertension. Among 131 hypertensive subjects in 58 sibships, concordant abnormalities in fasting serum lipid concentrations were observed in two or more siblings in 48% of the sibships. After adjusting for effects of antihypertensive medications, abnormal values reported in only 10% of the Lipid Research Clinics data were observed in 30% of patients for serum triglycerides, 19% for serum low-density lipoprotein cholesterol, and 39% for high-density lipoprotein cholesterol. More than one lipid level was abnormal in almost all concordant sibships, suggesting an association between hypertension and a syndrome of mixed lipid abnormalities, probably familial combined hyperlipidemia (renamed "familial combined dyslipidemia" because of common low high-density lipoprotein cholesterol levels). We conclude that familial dyslipidemic hypertension may be a specific syndrome with lipid abnormalities more severe than blood pressure elevations.
在犹他州，正在对60岁之前被诊断患有原发性高血压的基于人群的同胞兄弟姐妹进行筛查，以寻找两个或更多具有相同生化异常的高血压同胞，作为其特定类型高血压遗传病因的线索。在58个同胞关系中的131名高血压患者中，48%的同胞关系中有两个或更多同胞的空腹血脂浓度出现一致异常。在调整了抗高血压药物的影响后，脂质研究诊所数据中仅10%报告的异常值在30%的患者中出现于血清甘油三酯、19%出现于血清低密度脂蛋白胆固醇、39%出现于高密度脂蛋白胆固醇。几乎所有一致的同胞关系中都有不止一项血脂水平异常，这表明高血压与混合性脂质异常综合征之间存在关联，可能是家族性混合型高脂血症（由于常见的高密度脂蛋白胆固醇水平低而重新命名为“家族性混合性血脂异常”）。我们得出结论，家族性血脂异常性高血压可能是一种特定综合征，其脂质异常比血压升高更为严重。
