A U-shaped association between the LDL-cholesterol to HDL-cholesterol ratio and all-cause mortality in elderly hypertensive patients: a prospective cohort study

Lipids in Health and Disease

Lingjuan Zhu¹  Wei Zhou¹  Tao Wang¹  Yu Tao²  Congcong Ding²  Yu Yu²  Minghui Li²  Xiao Huang²  Huihui Bao³  Xiaoshu Cheng³ 

[1] Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China;Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, 330006, Nanchang, Jiangxi, China;Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, 330006, Nanchang, Jiangxi, China;Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China;

关键词: Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio;    U-shaped curve;    Mortality;    Hypertension;    Low-density lipoprotein cholesterol;    High-density lipoprotein cholesterol;    Cohort study;   

DOI  :  10.1186/s12944-020-01413-5

来源: Springer

【 摘 要 】

BackgroundThe low-density lipoprotein cholesterol/high-density lipoprotein- cholesterol (LDL-C/HDL-C) ratio is an excellent predictor of cardiovascular disease (CVD). However, previous studies linking the LDL-C/HDL-C ratio to mortality have yielded inconsistent results and been limited by short follow-up periods. Therefore, the aim of the present study was to determine whether the LDL-C/HDL-C ratio could be an effective predictor of all-cause mortality in elderly hypertensive patients.MethodsA total of 6941 hypertensive patients aged 65 years or older who were not treated with lipid-lowering drugs were selected from the Chinese Hypertension Registry for analysis. The endpoint of the study was all-cause mortality. The relationship between the LDL-C/HDL-C ratio and all-cause mortality was determined using multivariate Cox proportional hazards regression, smoothing curve fitting (penalized spline method), subgroup analysis and Kaplan–Meier survival curve analysis.ResultsDuring a median follow-up of 1.72 years, 157 all-cause deaths occurred. A U-shaped association was found between the LDL-C/HDL-C ratio and all-cause mortality. Patients were divided according to the quintiles of the LDL-C/HDL-C ratio. Compared to the reference group (Q3: 1.67–2.10), patients with both lower (Q1 and Q2) and higher (Q4 and Q5) LDL-C/HDL-C ratios had higher all-cause mortality (< 1.67: HR 1.81, 95% CI: 1.08–3.03; ≥2.10: HR 2.00, 95% CI: 1.18–3.39). Compared with the lower and higher LDL-C/HDL-C ratio groups, patients with LDL-C/HDL-C ratios of 1.67–2.10 had a significantly higher survival probability (log-rank P = 0.038).ConclusionsThe results suggest that there is a U-shaped association between the LDL-C/HDL-C ratio and all-cause mortality. Both lower and higher LDL-C/HDL-C ratios were associated with increased all-cause mortality in elderly hypertensive patients.

【 授权许可】

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