Ma Meijuan, Hao Jinxia, Liu Xiaoxiang, Lv Ying, Liu Fuqiang, Wei Na
Cadre Health Check-up Center, Shaanxi Provincial People's Hospital, Xi'an, P R China.
Department of Internal Medicine, Xi'an Jiaotong University Hospital, Xi'an, P R China.
Sci Rep. 2025 Jul 1;15(1):20657. doi: 10.1038/s41598-025-07141-z.
The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) is an emerging lipid parameter. An association has been demonstrated with cardiovascular mortality. This study aimed to investigate the link between NHHR and mortality among hypertensive patients.This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States from 1999 to 2018. The NHHR was derived from the lipid index. The association between NHHR and mortality in hypertensive patients was evaluated using multivariate Cox regression and Kaplan-Meier survival analysis, with restricted cubic spline curves (RCS) illustrating the nonlinear relationship. Subgroup analyses were conducted to assess the association's stability. The study included 16,259 patients with hypertension. Multivariate Cox regression analyses, adjusted for covariates, indicated that patients in NHHR quartiles Q2 and Q3 exhibited a 14% and 16% reduced risk of all-cause mortality, and a 32% and 33% reduced risk of cardiovascular mortality, respectively, compared to those in Q1. RCS analyses revealed a U-shaped relationship between NHHR and both all-cause and cardiovascular mortality in patients with hypertension. Subgroup analyses further maintained the robustness of this association across most subgroups. In hypertensive patients, NHHR exhibits a U-shaped relationship with both all-cause and cardiovascular mortality. This finding suggests that NHHR may serve as a new predictor of future mortality risk in hypertensive patients, providing a new marker for prognostic prevention in this special population.
非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值（NHHR）是一个新兴的血脂参数。已证实其与心血管疾病死亡率存在关联。本研究旨在探讨高血压患者中NHHR与死亡率之间的联系。本研究利用了1999年至2018年在美国进行的国家健康与营养检查调查（NHANES）的数据。NHHR由血脂指数得出。使用多变量Cox回归和Kaplan-Meier生存分析评估高血压患者中NHHR与死亡率之间的关联，受限立方样条曲线（RCS）用于说明非线性关系。进行亚组分析以评估该关联的稳定性。该研究纳入了16259例高血压患者。经协变量调整的多变量Cox回归分析表明，与处于Q1的患者相比，处于NHHR四分位数Q2和Q3的患者全因死亡率风险分别降低了14%和16%，心血管死亡率风险分别降低了32%和33%。RCS分析显示，高血压患者中NHHR与全因死亡率和心血管死亡率均呈U形关系。亚组分析进一步证实了该关联在大多数亚组中的稳健性。在高血压患者中，NHHR与全因死亡率和心血管死亡率均呈U形关系。这一发现表明，NHHR可能作为高血压患者未来死亡风险的新预测指标，为这一特殊人群的预后预防提供新的标志物。
