Impact of remnant cholesterol on arterial stiffness and mediating role of systolic blood pressure in chinese hypertensive adults.

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.