The Association of Elevated HDL Levels With Carotid Atherosclerosis in Middle-Aged Women With Untreated Essential Hypertension

Abstract

High-density lipoprotein cholesterol (HDL-C), a negative risk factor, is positively associated with a decreased risk of coronary heart disease. We investigated the association between high HDL-C levels and target organ damage (TOD) in never treated women with hypertension. We measured HDL-C levels in 117 women followed by estimation of TODs, that is, pulse wave velocity, microalbuminuria, left ventricular mass index, coronary flow reserve, and carotid intima–media thickness (cIMT). Women were divided into 2 groups (HDL_H and HDL_L), regarding HDL-C quartiles (upper quartile vs the first 3 lower quartiles). In HDL_H group (HDL ≥70 mg/dL), cIMT was nonindependently, negatively related to HDL-C (ρ = −.42, P < .05). Using receiver –operating characteristic curve (ROC) analysis in the HDL_H group, we concluded that the cutoff value of HDL ≥76.5 mg/dL moderately predicted the absence of carotid atherosclerosis (area under the curve: 0.77, P = .02; confidence interval: 0.57-0.97; sensitivity 73% and specificity 67%). Increased HDL-C may predict the absence of carotid atherosclerosis in middle-age women with untreated essential hypertension and consequently contribute to total cardiovascular risk estimation and treatment planning.