BMC public health · 2025
Impact of remnant cholesterol on arterial stiffness and mediating role of systolic blood pressure in chinese hypertensive adults.
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Yu Chao, Wang Tao, Zhu Lingjuan, Zhou Wei, Bao Huihui, Cheng Xiaoshu
Аннотация
BACKGROUND: This study aimed to investigate the association between remnant cholesterol (RC) levels and arterial stiffness in hypertensive patients and to explore potential effect modifiers.
METHODS: A cohort of 18,152 individuals diagnosed with hypertension was analyzed. RC was calculated using the Martin-Hopkins method, i.e., RC = total cholesterol (TC)-high-density lipoprotein cholesterol (HDL-C)-low-density lipoprotein cholesterol (LDL-C). Multivariate logistic regression models were employed to mitigate the influence of potential confounding factors and assess the association between RC and arterial stiffness (baPWV ≥ 1800 cm/s). Mediating analysis was conducted to determine the extent to which systolic blood pressure (SBP) mediates the correlation between RC and arterial stiffness.
RESULTS: Among 18152 study participants, 50.0% of males had an RC < 0.78 mmol/L, with a mean (SD) age of 59.6 (9.6) years. A significant positive correlation was observed between elevated RC levels and an increased risk of arterial stiffness (OR = 1.31; 95% CI: 1.14, 1.50). This positive correlation was also evident in hypertensive populations with SBP ≥ 140 mmHg (OR = 1.45; 95% CI: 1.21, 1.70). However, in populations with SBP < 140 mmHg, the association between RC and arterial stiffness appeared to require additional research and validation (OR = 1. 11; 95% CI: 0.86, 1.43). The results of the mediation analysis indicated that SBP mediated 21.54% of the correlation between RC and arterial stiffness.
CONCLUSIONS: This study demonstrated a positive association between RC and an increased risk of arterial stiffness among Chinese adults diagnosed with hypertension, particularly those with inadequate blood pressure control. SBP plays a mediating role in the association between RC and arterial stiffness.
KEY POINTS: RC is positively associated with arterial stiffness in hypertensive adults, particularly those with poor blood pressure control. Independent of other traditional lipid markers, RC may serve as a target for the prevention of developing arterial stiffness in hypertensive patients.
METHODS: A cohort of 18,152 individuals diagnosed with hypertension was analyzed. RC was calculated using the Martin-Hopkins method, i.e., RC = total cholesterol (TC)-high-density lipoprotein cholesterol (HDL-C)-low-density lipoprotein cholesterol (LDL-C). Multivariate logistic regression models were employed to mitigate the influence of potential confounding factors and assess the association between RC and arterial stiffness (baPWV ≥ 1800 cm/s). Mediating analysis was conducted to determine the extent to which systolic blood pressure (SBP) mediates the correlation between RC and arterial stiffness.
RESULTS: Among 18152 study participants, 50.0% of males had an RC < 0.78 mmol/L, with a mean (SD) age of 59.6 (9.6) years. A significant positive correlation was observed between elevated RC levels and an increased risk of arterial stiffness (OR = 1.31; 95% CI: 1.14, 1.50). This positive correlation was also evident in hypertensive populations with SBP ≥ 140 mmHg (OR = 1.45; 95% CI: 1.21, 1.70). However, in populations with SBP < 140 mmHg, the association between RC and arterial stiffness appeared to require additional research and validation (OR = 1. 11; 95% CI: 0.86, 1.43). The results of the mediation analysis indicated that SBP mediated 21.54% of the correlation between RC and arterial stiffness.
CONCLUSIONS: This study demonstrated a positive association between RC and an increased risk of arterial stiffness among Chinese adults diagnosed with hypertension, particularly those with inadequate blood pressure control. SBP plays a mediating role in the association between RC and arterial stiffness.
KEY POINTS: RC is positively associated with arterial stiffness in hypertensive adults, particularly those with poor blood pressure control. Independent of other traditional lipid markers, RC may serve as a target for the prevention of developing arterial stiffness in hypertensive patients.