Zhang Feng, Li Zhuqing, Wang Meng, Wang Yanxin, Lu Chengzhi
The First Central Clinical School, Tianjin Medical University, Tianjin, 300070, China.
Department of Cardiology, Tianjin First Center Hospital, Tianjin, 300192, China.
Aging Clin Exp Res. 2025 Jan 21;37(1):26. doi: 10.1007/s40520-024-02919-z.
NHHR, the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol, is a novel lipid marker associated with the risk of heart diseases and various health conditions. However, there is limited evidence regarding the relationship between NHHR and the onset of hypertension and heart diseases. The aim of this study was to investigate the association between NHHR and the new-onset hypertension and heart diseases among the Chinese middle-aged and older general population.
This prospective cohort study utilized data from a nationally representative sample of Chinese residents aged 45 and older, sourced from the China Health and Retirement Longitudinal Study (CHARLS). The primary outcomes of the study were new-onset hypertension and heart diseases. To investigate the relationship between the NHHR and the risk of new-onset hypertension and heart diseases, multivariate logistic regression models and the restricted cubic spline (RCS) method were employed. Additionally, the mediating effects of hypertension on the association between NHHR and heart diseases were assessed using the bootstrap method.
A total of 5349 participants were included in the final analysis and three groups of NHHR were identified, including low-stable, medium-stable, and high-stable NHHR. By 2020, 1,631 participants (30.5%) had been newly diagnosed with hypertension, while 1233 (23.1%) developed heart diseases. Compared to those with a low-stable NHHR, individuals in the other two groups showed a significantly increased risk of developing hypertension and heart diseases. The findings remained consistent across various sensitivity analyses. According to the RCS analysis, a partial U-shaped relationship existed between the NHHR and the risk of developing hypertension and heart diseases (P for nonlinear < 0.001). Furthermore, hypertension was found to partially mediate the association between NHHR and heart diseases.
The NHHR was closely associated with an increased risk of developing hypertension and heart diseases. In addition, the NHHR partially mediated the development of heart diseases by promoting hypertension progression. In the prevention and treatment of heart diseases, managing both lipid levels and blood pressure is crucial.
非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇之比（NHHR）是一种与心脏病风险和各种健康状况相关的新型血脂标志物。然而，关于NHHR与高血压和心脏病发病之间关系的证据有限。本研究的目的是调查中国中老年普通人群中NHHR与新发高血压和心脏病之间的关联。
这项前瞻性队列研究利用了来自中国健康与养老追踪调查（CHARLS）的45岁及以上中国居民全国代表性样本的数据。该研究的主要结局是新发高血压和心脏病。为了研究NHHR与新发高血压和心脏病风险之间的关系，采用了多变量逻辑回归模型和受限立方样条（RCS）方法。此外，使用Bootstrap方法评估了高血压在NHHR与心脏病关联中的中介作用。
最终分析共纳入5349名参与者，并确定了三组NHHR，包括低稳定、中稳定和高稳定NHHR。到2020年，1631名参与者（30.5%）被新诊断为高血压，1233名（23.1%）患心脏病。与低稳定NHHR者相比，其他两组个体患高血压和心脏病的风险显著增加。在各种敏感性分析中，结果保持一致。根据RCS分析，NHHR与患高血压和心脏病的风险之间存在部分U型关系（非线性P<0.001）。此外，发现高血压部分介导了NHHR与心脏病之间的关联。
NHHR与高血压和心脏病发病风险增加密切相关。此外，NHHR通过促进高血压进展部分介导了心脏病的发生。在心脏病的预防和治疗中，同时管理血脂水平和血压至关重要。
