EFFECTS OF HYPERTENSION AND DYSLIPIDEMIA ON THE DECLINE IN RENAL-FUNCTION

Experimental evidence suggests that in addition to hypertension, serum lipids might also accelerate the decline in renal function. We tested this hypothesis in 2702 dyslipidemic middle-aged men without renal di sease participating in the Helsinki Heart Study, a coronary primary pr evention trial. The decline in renal function was estimated from linea r regression slopes based on reciprocals of 10 serum creatinine determ inations over the study period. Renal function deteriorated 3% on aver age during the 5-year study, and hypertension accelerated this change. Subjects with an elevated ratio of low- to high-density lipoprotein c holesterol (>4.4) had a 20% faster decline than those with a ratio les s than 3.2. Both the contribution of the lipoprotein ratio and the pro tective effect of high-density lipoprotein cholesterol alone remained significant in multiple regression analyses. In the study of joint eff ects the contribution of lipids was confined to subjects with simultan eous elevation of blood pressure and lipids. The results suggest that in addition to hypertension, blood lipids also modify the decline in r enal function.