Lipids and the kidney.

Epidemiological studies have shown that hypertension and hypercholesterolemia are both risk factors for the development of cardiovascular disease.Although most investigations have focused on the independent nature of the risks resulting from hypertension and hypercholesterolemia, the data have also indicated a possible synergism in the combined influences of these and other risk factors on vascular disease. In addition, several studies have found a more frequent than expected occurrence of hypertension and hypercholesterolemia in the same individuals.It is unlikely that this association is the result of hypertension causing abnormalities in lipid metabolism. On the other hand, lipid abnormalities could participate in the pathogenesis of hypertension in a number of ways. The elevated systemic vascular resistance resulting from advanced atherosclerotic vascular disease, for example, may contribute to the development of hypertension in the elderly. However, recent experimental data have also suggested that lipid abnormalities associated with hypercholesterolemia may be involved in the pathogenesis of essential hypertension through mechanisms not dependent on the presence of overt vascular disease.This intriguing possibility casts a new light on what is already known about the synergistic effects of hypercholesterolemia and elevated blood pressure on atherosclerosis.