Ethnic and sex differences in the prevalence, treatment, and control of dyslipidemia among hypertensive adults in the GENOA study

Background: Two ethnically different, community-based samples of hypertensive adults were evaluated to determine the prevalence of dyslipidemia and how often dyslipidemia is drug-treated and controlled by such treatment. Methods: We studied 1286 non-Hispanic black hypertensive subjects from Jackson and 1070 non-Hispanic white hypertensive subjects from Rochester who participated in the Genetic Epidemiology Network of Arteriopathy study. Subjects were categorized according to presence of coronary heart disease and risk factors for coronary heart disease. Results: Prevalence of dyslipidemia was significantly greater among whites than blacks (women, 64.7% vs 49.5%; and men, 78.4% vs 56.7%; P<.001 for both) and among men than women (P≤.02 in each ethnic group). Among dyslipidemic subjects, treatment with lipid-regulating drugs was significantly more common among whites than blacks (women, 25.4% vs 16.4%, P=.001; and men, 32.6% vs 12.8%; P<.001), and among whites, treatment was significantly more common among men than women (P=.03). With drug treatment, control of dyslipidemia varied from 33.9% (white men) to 51.9% (black men), but the differences among ethnic-sex groups were not statistically significant. Conclusions: Dyslipidemia is highly prevalent in hypertensive adults. Fewer than one third of these adults are drug-treated, and fewer than half of those treated achieve recommended goals. Our findings suggest that an alarming 9 of 10 dyslipidemic hypertensive adults have untreated or undertreated dyslipidemia.