The clinical associations of dyslipidaemia among hypertensive adults presenting to the university teaching hospital (UTH), Lusaka adult hospital, Zambia.

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Mutengo, Katongo Hope
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The University of Zambia
Co-existence of hypertension and dyslipidaemia, also referred to as dyslipidaemic hypertension (DH), is known to have synergistic effect on the development of cardiovascular disease (CVD). In Zambia, there is scanty information on distinguishing features of dyslipidaemic hypertension. The study aimed at identifying factors associated with dyslipidaemic hypertension in adults at a tertiary hospital in Zambia. This was a cross-sectional study conducted from January 2017 to July, 2017. One hundred and sixty-one (161) participants were enrolled comprising 88 hypertensives and 73 controls. Relevant demographics, physical examinations, bio-electric impedance analysis and laboratory investigations were performed. Fasting lipid and lipoprotein parameters which included fasting serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDC-C) and triglycerides (TG) were analysed for lipid abnormalities. Data was analyzed using Stata version 15. The median age was 47 years (IQR; 39, 58) and 38 years (IQR; 38, 48) for the hypertensive and control groups, respectively. 53.3% of hypertensive and 46.7% of controls had at least one lipid abnormality. The factors associated with dyslipidaemic hypertension were; TC [aOR 2.41; 95%CI 1.57, 3.69; p<0.001], TG [aOR 3.28; 95%CI 1.12, 9.63; p=0.031] and HDL-C [aOR 0.10; 95%CI 0.03, 0.39; p=0.001]. On the other hand, the factors noted to be associated with dyslipidaemia only were; TC [aOR 3.61; 95%CI 2.08, 6.28; p<0.001], male gender [aOR 0.22; 95%CI 0.09, 0.53, p=0.001] and HDL-C [aOR 0.03; 95%CI 0.01, 0.11; p<0.001]. Traditional risk factors such as age, body mass index, waist circumference, waist-to-hip ratio did not show strong associations on multi-variate analysis. The study showed that increase in total cholesterol and triglycerides, and a reduction in high density lipoprotein cholesterol was significantly associated with dyslipidaemic hypertension. It is therefore imperative that management of hypertension should also focus on identifying and correcting associated lipid disorders.
Thesis of Master of Medicine in Internal Medicine.