Hypertension is quantitatively the most important risk factor for premature cardiovascular disease; it is more common than other risk factors such as cigarette smoking, dyslipidemia, and diabetes. Hypertension accounts for an estimated 54 percent of all strokes and 47 percent of all ischemic heart disease events globally. Hypertension increases the risk for a variety of cardiovascular diseases, including stroke, coronary artery disease, heart failure, and peripheral vascular disease. Coronary disease in men and stroke in women are the principal first cardiovascular events noted after hypertension onset, and in view of the evidence that the mortality rates are rising in younger people in the United States and the increasing impact of cardiovascular diseases in developing countries, greater attention must be given to prevention of these diseases. The increase in cardiovascular risk has primarily been described in terms of elevated systolic pressure in those over age 60 and elevation in diastolic pressure in younger individuals. Pulse pressure, which is the difference between the systolic and diastolic blood pressures and is determined primarily by large artery stiffness, is also a strong predictor of risk.
High concentrations of total and LDL cholesterol and low levels of high-density lipoprotein (HDL) cholesterol predict cardiovascular risk in both men and women. High triglyceride levels have been associated with greater risk in women only. The risk of cardiovascular disease increases by an average of 2% for each corresponding 1% rise in total cholesterol.
Clinical studies have shown that statins significantly reduce the risk of heart attack and death in patients with proven coronary artery disease (CAD), and can also reduce cardiac events in patients with high cholesterol levels who are at increased risk for heart disease. While best known as drugs that lower cholesterol, statins have several other beneficial effects that may also improve cardiac risk, and that may turn out to be even more important than their cholesterol-reducing properties.