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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Main Authors: Guoliang Liang, Wenhao Zhang, Xinxin Gu, Qiong Zhang, Ankang Liu, Xinran Qing, Jiangwei Ma
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
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
collection DOAJ
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.
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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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