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June 24, 1988, Vol 259, No. 24 >
ARTICLE | June 24, 1988

Familial Dyslipidemic Hypertension: Title and subTitle BreakEvidence From 58 Utah Families for a Syndrome Present in Approximately 12% of Patients With Essential Hypertension FREE

Roger R. Williams, MD; Steven C. Hunt, PhD; Paul N. Hopkins, MD, MSPH; Barry M. Stults, MD; Lily L. Wu, PhD; Sandra J. Hasstedt, PhD; Gary K. Barlow, MS; Susan H. Stephenson, PharmD; Jean-Marc Lalouel, MD, Dsc; Hiroshi Kuida, MD
[+] Author Affiliations

Reprint requests to Cardiovascular Genetics Research Clinic, 410 Chipeta Way, Room 161, Salt Lake City, UT 84108 (Dr Williams).


JAMA. 1988;259(24):3579-3586. doi:10.1001/jama.1988.03720240041032
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References

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.

(JAMA 1988;259:3579-3586)

REFERENCES

1 +
Williams RR, Hunt SC, Hasstedt SJ, et al:  The genetics of hypertension: An unsolved puzzle with many pieces , in Vogel F, Sperling K (eds): Human Genetics . Heidelberg, West Germany, Springer-Verlag, 1987;, pp 311-325.
2 +
Williams RR, Hunt SC, Hasstedt SJ, et al:  Biological markers of genetically predisposed hypertension , in Hofman A, Grobbee DE, Schalekamp MADH (eds): Early Pathogenesis of Primary Hypertension . Amsterdam, Elsevier Science Publishers, 1987;, pp 187-208.
3 +
Luft FC, Weinberger MH, Grim CE:  Sodium sensitivity and resistance in normotensive humans. Am J Med 1982;;72:726-736.
4 +
Laragh JH:  An approach to the classification of hypertensive states. Hosp Pract , (January) 1974;, pp 61-73.
5 +
Clegg G, Morgan DB, Davidson C:  The heterogeneity of essential hypertension: Relation between lithium efflux and sodium content of erythrocytes and a family history of hypertension. Lancet 1982;;2:891-894.
6 +
Strazzullo P, Siani A, Guglielmi S, et al:  Controlled trial of long-term oral calcium supplementation in essential hypertension. Hypertension 1986;;8:1084-1088.
7 +
Resnick LM, Laragh JH, Sealey JE, et al:  Divalent cations in essential hypertension: Relations between serum ionized calcium, magnesium, and plasma renin activity. N Engl J Med 1983;;309:888-891.
8 +
Altschul AM, Grommet JK, Slotkoff L, et al:  Sodium sensitivity , in Beers RF Jr, Bassett EG (eds): Nutritional Factors: Modulating Effects on Metabolic Processes . New York, Raven Press, 1981;, pp 45-62.
9 +
Miller JZ, Daugherty SA, Weinberger MH, et al:  Blood pressure response to dietary sodium restriction in normotensive adults. Hypertension 1983;;5:790-795.
10 +
Falkner B, Katz S, Canessa M, et al:  The response to long-term oral sodium loading in young blacks. Hypertension 1986;;8:1165-1168.
11 +
Hunt SC, Dadone MM, Williams RR, et al:  Familial correlations from genes and shared environment for urine, plasma, and intraerythrocytic sodium. Am J Med Genet 1987;;27:249-255.
12 +
Grim CE, Luft FC, Miller JZ, et al:  An approach to the evaluation of genetic influences on factors that regulate arterial blood pressure in man. Hypertension 1980;;2( (suppl 1) ):134-142.
13 +
Canessa M, Adragna N, Solomon HS, et al:  Increased sodium-lithium countertransport in red cells of patients with essential hypertension. N Engl J Med 1980;;302:772-776.
14 +
Garay RP, Meyer P:  A new test showing abnormal net Na+ and K+ fluxes in erythrocytes of essential hypertensive patients. Lancet 1979;;1:349-353.
15 +
Williams RR, Dadone MM, Hunt SC, et al:  The genetic epidemiology of hypertension: A review of past studies and current results for 948 persons in 48 Utah pedigrees , in Rao DC, Elston RC, Kuller LH, et al (eds): Genetic Epidemiology of Coronary Heart Disease: Past, Present, and Future . New York, Alan R Liss Inc, 1984;, pp 419-442.
16 +
Hunt SC, Williams RR, Smith JB, et al:  Associations of three erythrocyte cation transport systems with plasma lipids in Utah subjects. Hypertension 1986;;8:30-36.
17 +
Dadone MM, Smith JB, Wu L, et al:  Preliminary evidence for genetic determination of intraerythrocytic sodium concentration in Utah pedigrees. Am J Med Genet 1987;;27:39-44.

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1 +
Williams RR, Hunt SC, Hasstedt SJ, et al:  The genetics of hypertension: An unsolved puzzle with many pieces , in Vogel F, Sperling K (eds): Human Genetics . Heidelberg, West Germany, Springer-Verlag, 1987;, pp 311-325.
2 +
Williams RR, Hunt SC, Hasstedt SJ, et al:  Biological markers of genetically predisposed hypertension , in Hofman A, Grobbee DE, Schalekamp MADH (eds): Early Pathogenesis of Primary Hypertension . Amsterdam, Elsevier Science Publishers, 1987;, pp 187-208.
3 +
Luft FC, Weinberger MH, Grim CE:  Sodium sensitivity and resistance in normotensive humans. Am J Med 1982;;72:726-736.
4 +
Laragh JH:  An approach to the classification of hypertensive states. Hosp Pract , (January) 1974;, pp 61-73.
5 +
Clegg G, Morgan DB, Davidson C:  The heterogeneity of essential hypertension: Relation between lithium efflux and sodium content of erythrocytes and a family history of hypertension. Lancet 1982;;2:891-894.
6 +
Strazzullo P, Siani A, Guglielmi S, et al:  Controlled trial of long-term oral calcium supplementation in essential hypertension. Hypertension 1986;;8:1084-1088.
7 +
Resnick LM, Laragh JH, Sealey JE, et al:  Divalent cations in essential hypertension: Relations between serum ionized calcium, magnesium, and plasma renin activity. N Engl J Med 1983;;309:888-891.
8 +
Altschul AM, Grommet JK, Slotkoff L, et al:  Sodium sensitivity , in Beers RF Jr, Bassett EG (eds): Nutritional Factors: Modulating Effects on Metabolic Processes . New York, Raven Press, 1981;, pp 45-62.
9 +
Miller JZ, Daugherty SA, Weinberger MH, et al:  Blood pressure response to dietary sodium restriction in normotensive adults. Hypertension 1983;;5:790-795.
10 +
Falkner B, Katz S, Canessa M, et al:  The response to long-term oral sodium loading in young blacks. Hypertension 1986;;8:1165-1168.
11 +
Hunt SC, Dadone MM, Williams RR, et al:  Familial correlations from genes and shared environment for urine, plasma, and intraerythrocytic sodium. Am J Med Genet 1987;;27:249-255.
12 +
Grim CE, Luft FC, Miller JZ, et al:  An approach to the evaluation of genetic influences on factors that regulate arterial blood pressure in man. Hypertension 1980;;2( (suppl 1) ):134-142.
13 +
Canessa M, Adragna N, Solomon HS, et al:  Increased sodium-lithium countertransport in red cells of patients with essential hypertension. N Engl J Med 1980;;302:772-776.
14 +
Garay RP, Meyer P:  A new test showing abnormal net Na+ and K+ fluxes in erythrocytes of essential hypertensive patients. Lancet 1979;;1:349-353.
15 +
Williams RR, Dadone MM, Hunt SC, et al:  The genetic epidemiology of hypertension: A review of past studies and current results for 948 persons in 48 Utah pedigrees , in Rao DC, Elston RC, Kuller LH, et al (eds): Genetic Epidemiology of Coronary Heart Disease: Past, Present, and Future . New York, Alan R Liss Inc, 1984;, pp 419-442.
16 +
Hunt SC, Williams RR, Smith JB, et al:  Associations of three erythrocyte cation transport systems with plasma lipids in Utah subjects. Hypertension 1986;;8:30-36.
17 +
Dadone MM, Smith JB, Wu L, et al:  Preliminary evidence for genetic determination of intraerythrocytic sodium concentration in Utah pedigrees. Am J Med Genet 1987;;27:39-44.

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