The impact of dyslipidemia on cardiovascular risk stratification of hypertensive patients and association of lipid profile with other cardiovascular risk factors: Results from the ICEBERG study

OBJECTIVES
The ICEBERG study (Intensive/Initial Cardiovascular Examination regarding Blood pressure levels, Evaluation of Risk Groups) study focuses on the effect of dyslipidemia on cardiovascular risk evaluation and association of lipid profile with other risk factors.

STUDY DESIGN
The ICEBERG study consisted of two subprotocols: ICEBERG-1, conducted at 20 university hospitals (Referral group) and ICEBERG-2, conducted at 197 primary healthcare centers (Primary Care group). Each subprotocol had two patient profiles: patients previously diagnosed with essential hypertension and under medical treatment (Treated group), and patients with systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg, with no antihypertensive treatment for at least three months before inclusion (Untreated group). Dyslipidemia was evaluated and cardiovascular risk stratification performed according to the ESC/ESH 2003 guidelines.

RESULTS
A total of 1817 patients were analyzed. After incorporation of serum lipid values into cardiovascular risk stratification, the percentage of patients in “high” plus “very high” added risk groups increased to 55.2% (p<0.001), 62.6% (p=0.25), and 60.7% (p<0.001) in Treated Referral, Untreated Referral, and Untreated Primary Care groups, respectively. The corresponding figures estimated only by medical history and physical examination were 51.2%, 60.7%, and 54.2%, respectively. Serum lipid levels showed significant correlations with most risk factors.

CONCLUSION
Serum lipid levels are useful in stratifying hypertensive patients into cardiovascular risk groups more accurately, for appropriate antihypertensive treatment.