ASSESSMENT OF SERUM LIPID PROFILE IN HYPERTENSIVE PATIENTS : A CASE-CONTROL STUDY

Across the world, Hypertension is one of the most common risk factors for cardiovascular disease (CVD) [1] hypertension is more in developing countries, due to rapid urbanization, unhealthy diet, and lifestyle changes that have lead to an increased rate of CVD in Southeast Asia, including India [2]. According to the World Health Organization (WHO) report, India, by 2020, CVDs will be the leading cause of disability and death. Around 2.6 million people in India are expected to die due to coronary heart diseases by 2020 [3].


INTRODUCTION
Across the world, Hypertension is one of the most common risk factors for cardiovascular disease (CVD) [1] hypertension is more in developing countries, due to rapid urbanization, unhealthy diet, and lifestyle changes that have lead to an increased rate of CVD in Southeast Asia, including India [2]. According to the World Health Organization (WHO) report, India, by 2020, CVDs will be the leading cause of disability and death. Around 2.6 million people in India are expected to die due to coronary heart diseases by 2020 [3].
The association between hypertension and dyslipidemia is well established, and both may add up to increase patient's susceptibility to the development of Coronary Heart Disease (CHD). Hypertension is prone to cause Coronary Vascular Disease (CVD) in person with added risk factors such as elevated serum cholesterol. People with high blood pressure have more chances to have lipid abnormality than those with normal blood pressure [4].
Increased levels of triglyceride, cholesterol, and LDL-C are documented as risk factors for atherogenesis [5]. LDL-C in its oxidized or acetylated form has been identified as a significant atherogenic particle, as it not only loads macrophages with cholesterol for the formation of foam cells but also because it is Correspondence: Sushma Reddy. Department of Biochemistry, Koppal Institute of Medical Sciences, Near Gangavathy road, Koppal, Karnataka, Inida. Email: sushmareddyv6@gmail.com chemotactic for circulating monocytes, it is cytotoxic and can adversely alter coagulation pathways [6]. The blood level of HDL-C, in contrast, bears an inverse relationship of the risk of atherosclerosis and coronary heart disease that is higher the level, smaller the risk [7]. The objective of the study was to compare the lipid profile in Hypertensive patients and non-hypertensive individuals.

Sushma Reddy V 1 , Hari Prasad TV 2 , Surendra BV 2
Grouping: Out of the 60 subjects, 30 newly diagnosed hypertensive patients(cases) and the equal number of age and sex-matched without hypertension were selected as controls.
Five milliliters (5ml) venous blood was obtained between 08:00 and 09.00 a.m. after a 12-hour fasting period. The blood was allowed to clot for one hour. Centrifugation was done to separate the serum for 10 minutes, after which serum was isolated into a dry plain plastic screw-capped container and refrigerated (at -20˚C) before analyses. The analysis was done on fully auto analyzer XL 640 in Biochemistry Lab.
Serum total cholesterol levels was determined by enzymatic (CHOD-PAP) colorimetric method [8] and triglyceride by enzymatic (GPO-PAP) method [9] HDL-cholesterol and LDL-cholesterol were estimated using precipitant [10] and Friedewald formula [11,12]. Above all, parameters under investigation were determined in the serum of patients and controls using commercially available reagent kits.
Statistical analysis: By student's " t " test statistical significance was evaluated between control and study groups.

Controls
Cases   These findings of Significantly higher levels of serum cholesterol, triglyceride, and LDL-cholesterol in hypertensive patients than those of the control group were entirely in agreement with the results of some previous studies.
Sabri [13], and Yin [14], showed that total cholesterol level was higher in hypertensive patients than nonhypertensive subjects.
Shahadat et al., [15] Adedeji et al., [16] and Shah et al. [17] in their respective studies showed that total cholesterol and triglycerides were higher in hypertensive patients Oparil et al. explained different mechanisms through which First, arteriosclerosis in the larger arteries due to the deposition of collagen leads to arterial stiffness. This may lead to increased SBP seen with increasing age. Besides , lipidemias lead to endothelial dysfunction and im with more TC and less HDL-C levels. And also, lated with TC levels [20]. Besides, dyslipidemia can also cause damage to the renal microvasculature with the dyslipidemia is linked to renal decline [21].
However, no statistical significance of HDL-Cholesterol was found among Hypertensive patients in comparison with the healthy volunteers.

CONCLUSION
Dyslipidemia is associated with hypertension. Hypertension and dyslipidemia can be modified either by proper lifestyle changes or medical management or by the combination of both. This study recommends that hypertensive patients need the measurement of blood pressure and lipid profile at regular intervals to prevent cardiovascular diseases.