La importanza del controllo combinato pressorio e lipidico nel paziente con profilo di rischio cardiovascolare elevato

Summary Hypercholesterolemia and hypertension are two of the main risk factors responsible of high incidence and prevalence of cardiovascular (CV) diseases. They are frequently associated in the same subject where they cause an exponential increase of CV risk. However a dual therapeutic strategy is essential to lower CV risk profile of the patients showing both risk factors. More recently some studies have shown that hypercholesterolemia has an important role not only in the development of CV diseases but also in the onset and progression of the hypertensive disease. This suggest the existence of a common pathophysiologic mechanism and, consequently, emphasize the importance of an integrated therapeutic intervention. A prevalent therapeutic role in patients with hypertension and hypercholesterolemia has been suggested for statins and ARB’s not only because they can correct both risk factors individually, but also because of the sinergy of actions between these drugs which can be related to their possible pleiotropic effects. In fact it seems that the association between statins and AIIRB can improve the capacity of endothelium-mediated vasodilatation and lower functional alterations of the vessel walls, both of cytokine-mediated and of inflammatory nature, which we know them to be key mechanisms in the developing of the atherosclerotic disease.