Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
Hypertens Res. 2024 May;47(5):1157-1166. doi: 10.1038/s41440-023-01558-7. Epub 2024 Jan 11.
Remnant cholesterol (RC) has been associated with atherosclerotic cardiovascular disease, but its relationship with hypertension remains unclear. This prospective cohort study aimed to investigate the association between RC and subsequent hypertension risk. Data from the UK Biobank, comprising 295,062 participants initially free of hypertension, were analyzed. Cox proportional hazards regression assessed the association between RC quartiles and hypertension risk. Discordance analysis evaluated the risk of hypertension in discordant/concordant groups of RC and low-density lipoprotein cholesterol (LDL-C) using the difference in percentile units (>10 units). Restricted cubic spline curves were used to model the relationship between RC and hypertension risk. The mean ± SD age of participants was 55.1 ± 8.1 years, with 40.6% being men and 94.7% White. During a median follow-up of 12.8 years, 39,038 participants developed hypertension. Comparing extreme quartiles of RC, the hazard ratio (HR) for incident hypertension was 1.20 (95% CI: 1.17-1.24). After adjusting for traditional risk factors, each 1 mmol/L increase in RC levels was associated with a 27% higher risk of incident hypertension (HR: 1.27; 95% CI: 1.23-1.31). The discordant group with high RC/low LDL-C exhibited a higher risk of incident hypertension compared to the concordant group (HR: 1.06; 95% CI: 1.03-1.09). Spline curves further demonstrated a positive association between RC and the risk of incident hypertension. We concluded that elevated RC emerged as an independent risk factor of incident hypertension, extending beyond traditional risk factors. Monitoring RC levels and implementing interventions to lower RC may have potential benefits in preventing hypertension.
残余胆固醇 (RC) 与动脉粥样硬化性心血管疾病有关，但它与高血压的关系尚不清楚。本前瞻性队列研究旨在探讨 RC 与随后发生高血压风险之间的关系。对最初无高血压的 295062 名 UK Biobank 参与者的数据进行了分析。使用 Cox 比例风险回归评估了 RC 四分位数与高血压风险之间的关联。差异分析评估了 RC 和低密度脂蛋白胆固醇 (LDL-C) 不一致/一致组中高血压的风险，使用百分位单位的差值（>10 个单位）。限制性三次样条曲线用于模拟 RC 与高血压风险之间的关系。参与者的平均年龄为 55.1±8.1 岁，其中 40.6%为男性，94.7%为白人。中位随访 12.8 年后，39038 名参与者发生了高血压。与 RC 极端四分位数相比，高血压的发病风险比（HR）为 1.20（95%CI：1.17-1.24）。调整传统危险因素后，RC 水平每增加 1mmol/L，新发高血压的风险增加 27%（HR：1.27；95%CI：1.23-1.31）。RC 高/LDL-C 低的不一致组发生高血压的风险高于一致组（HR：1.06；95%CI：1.03-1.09）。样条曲线进一步表明 RC 与新发高血压风险之间存在正相关关系。我们得出结论，升高的 RC 是新发高血压的独立危险因素，超出了传统危险因素。监测 RC 水平并实施降低 RC 的干预措施可能对预防高血压有潜在益处。
