Department of Neuroscience, Reproductive Sciences and Dentistry (V.T., A.F.), "Federico II" University, Naples, Italy.
Department of Advanced Biomedical Sciences (R.I., C.M., M.V.M., P.G., M.L., G.S., B.T.), "Federico II" University, Naples, Italy.
Hypertension. 2022 Oct;79(10):2355-2363. doi: 10.1161/HYPERTENSIONAHA.122.19912. Epub 2022 Aug 15.
Emerging evidence suggests that elevated circulating levels of HDL-C (high-density lipoprotein cholesterol) could be linked to an increased mortality risk. However, to the best of our knowledge, the relationship between HDL-C and specific cardiovascular events has never been investigated in patients with hypertension.
To fill this knowledge gap, we analyzed the relationship between HDL-C levels and cardiovascular events in hypertensive patients within the Campania Salute Network in Southern Italy.
We studied 11 987 patients with hypertension, who were followed for 25 534 person-years. Our population was divided in 3 groups according to the HDL-C plasma levels: HDL-C<40 mg/dL (low HDL-C); HDL-C between 40 and 80 mg/dL (medium HDL-C); and HDL-C>80 mg/dL (high HDL-C). At the follow-up analysis, adjusting for potential confounders, we observed a total of 245 cardiovascular events with a significantly increased risk of cardiovascular events in the low HDL-C group and in the high HDL-C arm compared with the medium HDL-C group. The spline analysis revealed a nonlinear U-shaped association between HDL-C levels and cardiovascular outcomes. Interestingly, the increased cardiovascular risk associated with high HDL-C was not confirmed in female patients.
Our data demonstrate that there is a U-shaped association between HDL-C and the risk of cardiovascular events in male patients with hypertension.
新出现的证据表明，循环高密度脂蛋白胆固醇（HDL-C）水平升高可能与死亡率增加有关。然而，据我们所知，在高血压患者中，HDL-C 与特定心血管事件之间的关系从未被研究过。
为了填补这一知识空白，我们分析了意大利南部坎帕尼亚萨卢特网络中高血压患者的 HDL-C 水平与心血管事件之间的关系。
我们研究了 11987 名高血压患者，随访时间为 25534 人年。根据 HDL-C 血浆水平，我们将人群分为 3 组：HDL-C<40mg/dL（低 HDL-C）；HDL-C 在 40-80mg/dL 之间（中 HDL-C）；和 HDL-C>80mg/dL（高 HDL-C）。在随访分析中，调整潜在混杂因素后，我们观察到总共 245 例心血管事件，与中 HDL-C 组相比，低 HDL-C 组和高 HDL-C 组发生心血管事件的风险显著增加。样条分析显示，HDL-C 水平与心血管结局之间存在非线性 U 形关联。有趣的是，与高 HDL-C 相关的增加的心血管风险在女性患者中并未得到证实。
我们的数据表明，在高血压男性患者中，HDL-C 与心血管事件风险之间存在 U 形关联。
