Association Between Lipid Profiles and Arterial Stiffness in Chinese Patients With Hypertension: Insights From the CSPPT

Abstract

Arterial stiffness plays a key role in the pathogenesis of cardiovascular disease. However, the relationship between lipid levels and arterial stiffness is controversial. We aimed to investigate the association between lipid parameters and brachial–ankle pulse-wave velocity (baPWV) in Chinese patients with hypertension. A total of 14 071 participants with hypertension in the China Stroke Primary Prevention Trial (CSPPT) were enrolled in the present study. Patients were assigned to 4 equal groups according to their baPWV. Participants in the highest baPWV group were older with a higher prevalence of stroke and diabetes mellitus as well as higher body mass index (BMI), blood pressure, fasting plasma glucose, uric acid, total cholesterol (TC), triglycerides (TG), homocysteine (Hcy), and vitamin B12 levels (P < .001). After adjusting for age, sex, BMI, and other cardiovascular risks, high-density lipoprotein cholesterol (HDL-C) was negatively related to baPWV (β = −0.22, P = .012), TC (β = 0.08, P = 0.001), TG (β = 0.14, P = .001); non-HDL-C (β = 0.12, P = .001) and positively related to baPWV. The effect was not observed for low-density lipoprotein cholesterol (LDL-C; β = 0.12, P = .335).These results suggested that non-HDL-C, TG, and TC were associated with arterial stiffness in a Chinese population with hypertension. HDL-C was inversely associated with arterial stiffness.

Keywords

arterial stiffness brachial-ankle pulse wave velocity high-density lipoprotein low-density lipoprotein cholesterol hypertension

Get full access to this article

View all access options for this article.

References

Ohkuma

Tomiyama

Ninomiya

; Collaborative Group for Japan Brachial-Ankle pulse wave VELocity individual participant data meta-analysis of prospective studies (J-BAVEL). Proposed cutoff value of brachial-ankle pulse wave velocity for the management of hypertension. Circ J. 2017;81(10):1540–1542.

Turin

Kita

Rumana

. Brachial-ankle pulse wave velocity predicts all-cause mortality in the general population: findings from the Takashima study, Japan. Hypertens Res. 2010;33(9):922–925.

Tanaka

Munakata

Kawano

. Comparison between carotid-femoral and brachial-ankle pulse wave velocity as measures of arterial stiffness. J Hypertens. 2009;27(10):2022–2027.

Ohkuma

Ninomiya

Tomiyama

; Collaborative Group for J-BAVEL (Japan Brachial-Ankle Pulse Wave Velocity Individual Participant Data Meta-Analysis of Prospective Studies)*. Brachial-ankle pulse wave velocity and the risk prediction of cardiovascular disease: an individual participant data meta-analysis. Hypertension. 2017;69(6):1045–1052.

Zhou

Zhang

Yao

. Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population. J Biomed Res. 2014;28(4):262–268.

Zhao

Gong

. Association of lipid profiles and the ratios with arterial stiffness in middle-aged and elderly Chinese. Lipids Health Dis. 2014;13:37.

Gomez-Sanchez

Garcia-Ortiz

Patino-Alonso

; MARK Group. Association of metabolic syndrome and its components with arterial stiffness in Caucasian subjects of the MARK study: a cross-sectional trial. Cardiovasc Diabetol. 2016;15(1):148.

Yiming

Zhou

. Reference values of brachial-ankle pulse wave velocity according to age and blood pressure in a central Asia population. PLoS One. 2017;12(4):e0171737.

Huo

Qin

; CSPPT Investigators. Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China: the CSPPT randomized clinical trial. JAMA. 2015;313(13):1325–1335.

10.

Momin

Zhang

. Body mass index is inversely associated with arterial stiffness in Chinese adults with primary hypertension: results from the China Stroke Primary Prevention Trial (CSPPT). Clin Exp Hypertens. 2017;39(5):394–401.

11.

Ahn

Kim

. High-density lipoprotein cholesterol (HDL-C) in cardiovascular disease: effect of exercise training. Integr Med Res. 2016;5(3):212–215.

12.

Brites

Martin

Guillas

Kontush

. Antioxidative activity of high-density lipoprotein (HDL): mechanistic insights into potential clinical benefit. BBA Clin. 2017;8:66–77.

13.

Di Angelantonio

Sarwar

Perry

. Emerging Risk Factors Collaboration. Major lipids, apolipoproteins, and risk of vascular disease. JAMA. 2009;302(18):1993–2000.

14.

Harrison

Holmes

Humphries

. Mendelian randomisation, lipids, and cardiovascular disease. Lancet. 2012;380(9841):543–545.

15.

Ito

Arima

Fujiyoshi

; NIPPON DATA90 Research Group. Relationship between non-high-density lipoprotein cholesterol and the long-term mortality of cardiovascular diseases: NIPPON DATA 90. Int J Cardiol. 2016;220:262–267.

16.

Expert Dyslipidemia Panel of the International Atherosclerosis Society Panel members. An International Atherosclerosis Society Position Paper: global recommendations for the management of dyslipidemia—full report. J Clin Lipidol. 2014;8(1):29–60.

17.

Boekholdt

Arsenault

Mora

. Association of LDL cholesterol, non-HDL cholesterol, and apolipoprotein B levels with risk of cardiovascular events among patients treated with statins: a meta-analysis. JAMA. 2012;307(12):1302–1309.

18.

Puri

Nissen

Shao

. Non-HDL cholesterol and triglycerides: implications for coronary atheroma progression and clinical events. Arterioscler Thromb Vasc Biol. 2016;36(11):2220–2228.

19.

Poledne

Kralova Lesna

Kralova

Fronek

Cejkova

. The relationship between non-HDL cholesterol and macrophage phenotypes in human adipose tissue. J Lipid Res. 2016;57(10):1899–1905.

20.

Nordestgaard

Varbo

. Triglycerides and cardiovascular disease. Lancet. 2014;384(9943):626–635.

21.

Pitha

Kovái

Blahová

. Fasting and nonfasting triglycerides in cardiovascular and other diseases. Physiol Res. 2015;64(suppl 3):S323–S330.

22.

Valdivielso

Ramírez-Bueno

Ewald

. Current knowledge of hypertriglyceridemic pancreatitis. Eur J Intern Med. 2014;25(8):689–694.

23.

Sundaram

Curtis

Amir Alipour

. The apolipoprotein C-III (Gln38Lys) variant associated with human hypertriglyceridemia is a gain-of-function mutation. J Lipid Res. 2017;58(11):2188–2196.

24.

Buchan

Boddy

Despres

. Utility of the hypertriglyceridemic waist phenotype in the cardiometabolic risk assessment of youth stratified by body mass index. Pediatr Obes. 2016;11(4):292–298.

25.

Pokharel

Tang

Bhardwaj

. Association of low-density lipoprotein pattern with mortality after myocardial infarction: Insights from the TRIUMPH study. J Clin Lipidol. 2017;11(6):1458–1470.e4.

26.

Chu

Dai

. Associations of risk factors in childhood with arterial stiffness 26 years later: the Hanzhong adolescent hypertension cohort. J Hypertens. 2017;35(suppl 1):S10–S15.

27.

Ravnskov

Diamond

Hama

. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review. BMJ Open. 2016;6(6):e010401.

28.

Sniderman

McQueen

Contois

Williams

Furberg

. Why is non-high-density lipoprotein cholesterol a better marker of the risk of vascular disease than low-density lipoprotein cholesterol? J Clin Lipidol. 2010;4(3):152–155.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.54 MB