A non-linear association of low-density lipoprotein cholesterol with all-cause and cardiovascular mortality among patients with hypertension
BackgroundAlthough a few studies have examined the correlation between low-density lipoprotein cholesterol (LDL-C) and mortality, no study has explored these associations in hypertensive populations. This study aims to investigate the relationship between low-density lipoprotein cholesterol and card...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1469848/full |
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| author | Guoliang Liang Guoliang Liang Wenhao Zhang Xinxin Gu Qiong Zhang Ankang Liu Xinran Qing Jiangwei Ma |
| author_facet | Guoliang Liang Guoliang Liang Wenhao Zhang Xinxin Gu Qiong Zhang Ankang Liu Xinran Qing Jiangwei Ma |
| author_sort | Guoliang Liang |
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| description | BackgroundAlthough a few studies have examined the correlation between low-density lipoprotein cholesterol (LDL-C) and mortality, no study has explored these associations in hypertensive populations. This study aims to investigate the relationship between low-density lipoprotein cholesterol and cardiovascular and all-cause mortality in adults with hypertension.MethodsHypertensive participants aged ≥18 years from the National Health and Nutrition Examination Survey 1999–2018 with blood lipid testing data and complete follow-up data until 31 December 2019 were enrolled in the analysis. Univariate and multivariate Cox regression were conducted for the calculation of hazard ratios and 95% confidence intervals. A restricted cubic spline curve was performed to visually represent the relationship between LDL-C and mortality. Kaplan–Meier survival analysis and stratification analysis were also carried out.ResultsWe finally analysed a cohort of 9,635 participants (49.6% male, mean age of 59.4 years). After a median follow-up of 98 months, there were 2,283 (23.7%) instances of all-cause fatalities, with 758 (7.9%) cases attributed to cardiovascular disease. Multivariate Cox regression analysis showed that lower levels of LDL-C were associated with a higher risk of all-cause and cardiovascular mortality; the LDL-C group’s lowest level (<2.198 mmol/L) still showed a 19.6% increased risk of all-cause mortality (p = 0.0068) in the model that was completely adjusted. Both all-cause mortality and cardiovascular mortality showed a non-linear association with LDL-C concentration in restricted cubic spline regression analysis.ConclusionsIn individuals with hypertension, LDL-C was linked to cardiovascular and all-cause mortality. It was further demonstrated that this relationship was non-linear. |
| format | Article |
| id | doaj-art-009d82143e60472faa76d61fca027ae4 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-009d82143e60472faa76d61fca027ae42024-12-23T06:38:52ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-12-011110.3389/fcvm.2024.14698481469848A non-linear association of low-density lipoprotein cholesterol with all-cause and cardiovascular mortality among patients with hypertensionGuoliang Liang0Guoliang Liang1Wenhao Zhang2Xinxin Gu3Qiong Zhang4Ankang Liu5Xinran Qing6Jiangwei Ma7Department of Cardiovascular Medicine, Fengxian District Central Hospital, Shanghai, ChinaMedical School of Anhui University of Science and Technology, Huainan, ChinaDepartment of Cardiovascular Medicine, Fengxian District Central Hospital, Shanghai, ChinaDepartment of Cardiovascular Medicine, Fengxian District Central Hospital, Shanghai, ChinaDepartment of Cardiovascular Medicine, Fengxian District Central Hospital, Shanghai, ChinaDepartment of Cardiovascular Medicine, Fengxian District Central Hospital, Shanghai, ChinaDepartment of Cardiovascular Medicine, Fengxian District Central Hospital, Shanghai, ChinaDepartment of Cardiovascular Medicine, Fengxian District Central Hospital, Shanghai, ChinaBackgroundAlthough a few studies have examined the correlation between low-density lipoprotein cholesterol (LDL-C) and mortality, no study has explored these associations in hypertensive populations. This study aims to investigate the relationship between low-density lipoprotein cholesterol and cardiovascular and all-cause mortality in adults with hypertension.MethodsHypertensive participants aged ≥18 years from the National Health and Nutrition Examination Survey 1999–2018 with blood lipid testing data and complete follow-up data until 31 December 2019 were enrolled in the analysis. Univariate and multivariate Cox regression were conducted for the calculation of hazard ratios and 95% confidence intervals. A restricted cubic spline curve was performed to visually represent the relationship between LDL-C and mortality. Kaplan–Meier survival analysis and stratification analysis were also carried out.ResultsWe finally analysed a cohort of 9,635 participants (49.6% male, mean age of 59.4 years). After a median follow-up of 98 months, there were 2,283 (23.7%) instances of all-cause fatalities, with 758 (7.9%) cases attributed to cardiovascular disease. Multivariate Cox regression analysis showed that lower levels of LDL-C were associated with a higher risk of all-cause and cardiovascular mortality; the LDL-C group’s lowest level (<2.198 mmol/L) still showed a 19.6% increased risk of all-cause mortality (p = 0.0068) in the model that was completely adjusted. Both all-cause mortality and cardiovascular mortality showed a non-linear association with LDL-C concentration in restricted cubic spline regression analysis.ConclusionsIn individuals with hypertension, LDL-C was linked to cardiovascular and all-cause mortality. It was further demonstrated that this relationship was non-linear.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1469848/fulllow-density lipoprotein cholesterolall-cause mortalitycardiovascular mortalityhypertensionNHANES |
| spellingShingle | Guoliang Liang Guoliang Liang Wenhao Zhang Xinxin Gu Qiong Zhang Ankang Liu Xinran Qing Jiangwei Ma A non-linear association of low-density lipoprotein cholesterol with all-cause and cardiovascular mortality among patients with hypertension Frontiers in Cardiovascular Medicine low-density lipoprotein cholesterol all-cause mortality cardiovascular mortality hypertension NHANES |
| title | A non-linear association of low-density lipoprotein cholesterol with all-cause and cardiovascular mortality among patients with hypertension |
| title_full | A non-linear association of low-density lipoprotein cholesterol with all-cause and cardiovascular mortality among patients with hypertension |
| title_fullStr | A non-linear association of low-density lipoprotein cholesterol with all-cause and cardiovascular mortality among patients with hypertension |
| title_full_unstemmed | A non-linear association of low-density lipoprotein cholesterol with all-cause and cardiovascular mortality among patients with hypertension |
| title_short | A non-linear association of low-density lipoprotein cholesterol with all-cause and cardiovascular mortality among patients with hypertension |
| title_sort | non linear association of low density lipoprotein cholesterol with all cause and cardiovascular mortality among patients with hypertension |
| topic | low-density lipoprotein cholesterol all-cause mortality cardiovascular mortality hypertension NHANES |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1469848/full |
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