Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Diabetes Metab J. 2019 Feb;43(1):114-122. doi: 10.4093/dmj.2018.0053. Epub 2018 Sep 28.
Recent studies have suggested that high density lipoprotein (HDL) cholesterol is inversely associated with the development of hypertension. We aimed to determine the association between different HDL cholesterol subclasses and risk of future hypertension.
A total of 270 Japanese Americans (130 men, 140 women) without hypertension between the ages of 34 to 75 years were enrolled. Blood pressure was measured with a mercury sphygmomanometer, and average blood pressure was calculated. Incident hypertension was determined 5 to 6 and 10 to 11 years after enrollment. HDL2, HDL3, and total HDL cholesterol were measured at baseline.
During 10 years of follow-up, the cumulative incidence of hypertension was 28.1% (76/270). In univariate analysis, age, diabetes, waist circumference, systolic and diastolic blood pressure, fasting glucose, insulin resistance index, total and low density lipoprotein cholesterol, and visceral adipose tissue were significant predictors for incident hypertension. Among the HDL cholesterol subclass, HDL2 cholesterol was inversely associated with hypertension incidence, but both total and HDL3 cholesterol were not. In addition, HDL2/HDL cholesterol was inversely associated with future hypertension risk. In multivariate analysis, age (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.26 to 2.31; =0.001), systolic blood pressure (OR, 1.83; 95% CI, 1.31 to 2.56; <0.001), and HDL2/HDL cholesterol (OR, 0.71; 95% CI, 0.52 to 0.98; =0.035), were associated with future development of hypertension.
A higher proportion of HDL2 cholesterol among total HDL cholesterol predicted a lower risk for incident hypertension. However, concentrations of total HDL, HDL2, and HDL3 cholesterol were not independent predictors of incident hypertension.
最近的研究表明，高密度脂蛋白（HDL）胆固醇与高血压的发展呈负相关。我们旨在确定不同的 HDL 胆固醇亚类与未来高血压风险之间的关联。
共纳入 270 名年龄在 34 至 75 岁之间、无高血压的日本裔美国人（男性 130 人，女性 140 人）。使用汞柱血压计测量血压，计算平均血压。在入组后 5 至 6 年和 10 至 11 年确定高血压的发生情况。在基线时测量 HDL2、HDL3 和总 HDL 胆固醇。
在 10 年的随访期间，高血压的累积发病率为 28.1%（76/270）。在单变量分析中，年龄、糖尿病、腰围、收缩压和舒张压、空腹血糖、胰岛素抵抗指数、总胆固醇和低密度脂蛋白胆固醇以及内脏脂肪组织是高血压发生的显著预测因子。在 HDL 胆固醇亚类中，HDL2 胆固醇与高血压发病呈负相关，但总胆固醇和 HDL3 胆固醇则不然。此外，HDL2/HDL 胆固醇与未来高血压风险呈负相关。在多变量分析中，年龄（比值比[OR]，1.71；95%置信区间[CI]，1.26 至 2.31；=0.001）、收缩压（OR，1.83；95% CI，1.31 至 2.56；<0.001）和 HDL2/HDL 胆固醇（OR，0.71；95% CI，0.52 至 0.98；=0.035）与高血压的发生有关。
总 HDL 胆固醇中 HDL2 胆固醇的比例较高预示着高血压发病风险较低。然而，总 HDL、HDL2 和 HDL3 胆固醇的浓度并不是高血压发病的独立预测因子。
