Association of Cumulative Exposure to Triglyceride and Remnant Cholesterol With the Risk of Cardiovascular Disease in Hypertensive Patients With Target LDL‐C

ABSTRACT Hypertensive patients are at high risk of cardiovascular disease (CVD) and require intensive lipids management. Triglycerides (TG) and remnant cholesterol (RC) contribute to residual risk beyond low‐density lipoprotein cholesterol (LDL‐C), and cumulative exposure reflects a more comprehensi...

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Main Authors: Shuang Guo, Chi Wang, Taoyu Hu, Lihua Lan, Zhen Ge, Jianxiang Huang, Shuohua Chen, Shouling Wu, Hao Xue
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:The Journal of Clinical Hypertension
Subjects:
Online Access:https://doi.org/10.1111/jch.70084
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author Shuang Guo
Chi Wang
Taoyu Hu
Lihua Lan
Zhen Ge
Jianxiang Huang
Shuohua Chen
Shouling Wu
Hao Xue
author_facet Shuang Guo
Chi Wang
Taoyu Hu
Lihua Lan
Zhen Ge
Jianxiang Huang
Shuohua Chen
Shouling Wu
Hao Xue
author_sort Shuang Guo
collection DOAJ
description ABSTRACT Hypertensive patients are at high risk of cardiovascular disease (CVD) and require intensive lipids management. Triglycerides (TG) and remnant cholesterol (RC) contribute to residual risk beyond low‐density lipoprotein cholesterol (LDL‐C), and cumulative exposure reflects a more comprehensive assessment. However, their impact on hypertensive patients with target LDL‐C levels remains unclear. A total of 9046 hypertensive participants with target LDL‐C levels who completed three health examinations (2006‒2010) were enrolled and followed until December 31, 2022. Cumulative burden was calculated as the average level multiplied by the interval between assessments. The primary outcome included a composite of CVD events (myocardial infarction [MI], ischemic stroke [IS], and hemorrhage stroke [HS]). Participants were categorized into four groups according to cumulative triglyceride (cumTG) (≥5.66 vs. <5.66 [median, mmol/L]) and cumulative RC (cumRC) (≥4.20 vs. <4.20 [median, mmol/L]): low cumTG and low cumRC, high cumTG and low cumRC, low cumTG and high cumRC, and high cumTG and high cumRC. Cox models were used to calculate the hazard ratio (HR) and 95% confidence intervals (CI) between the cumulative burden and CVD risk. During a median follow‐up of 15.97 years, 1415 participants developed CVD. After multivariable adjustment, compared to the low cumTG/low cumRC group, CVD risk was higher in the high cumTG/high cumRC (HR 1.43, 95% CI 1.24‒1.64) and low cumTG/high cumRC groups (HR 1.24, 95% CI 1.05–1.47), but not in the high cumTG/low cumRC group (HR 1.06, 95% CI 0.89–1.25). In hypertensive patients with target LDL‐C levels, high cumRC, rather than cumTG, is associated with an increased risk of CVD. Trial Registration: ChiCTR‐TNC‐11001489
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institution Kabale University
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series The Journal of Clinical Hypertension
spelling doaj-art-ae1f535ce641413b8e8094e6751d00a22025-08-20T03:56:10ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-06-01276n/an/a10.1111/jch.70084Association of Cumulative Exposure to Triglyceride and Remnant Cholesterol With the Risk of Cardiovascular Disease in Hypertensive Patients With Target LDL‐CShuang Guo0Chi Wang1Taoyu Hu2Lihua Lan3Zhen Ge4Jianxiang Huang5Shuohua Chen6Shouling Wu7Hao Xue8Department of Cardiology, The Sixth Medical Center Chinese PLA General Hospital Beijing ChinaDepartment of Cardiology, The Sixth Medical Center Chinese PLA General Hospital Beijing ChinaSchool of Medicine Nankai University Tianjin ChinaSchool of Medicine Nankai University Tianjin ChinaSchool of Medicine Nankai University Tianjin ChinaSchool of Medicine Nankai University Tianjin ChinaDepartment of Cardiology Kailuan General Hospital Tangshan ChinaDepartment of Cardiology Kailuan General Hospital Tangshan ChinaDepartment of Cardiology, The Sixth Medical Center Chinese PLA General Hospital Beijing ChinaABSTRACT Hypertensive patients are at high risk of cardiovascular disease (CVD) and require intensive lipids management. Triglycerides (TG) and remnant cholesterol (RC) contribute to residual risk beyond low‐density lipoprotein cholesterol (LDL‐C), and cumulative exposure reflects a more comprehensive assessment. However, their impact on hypertensive patients with target LDL‐C levels remains unclear. A total of 9046 hypertensive participants with target LDL‐C levels who completed three health examinations (2006‒2010) were enrolled and followed until December 31, 2022. Cumulative burden was calculated as the average level multiplied by the interval between assessments. The primary outcome included a composite of CVD events (myocardial infarction [MI], ischemic stroke [IS], and hemorrhage stroke [HS]). Participants were categorized into four groups according to cumulative triglyceride (cumTG) (≥5.66 vs. <5.66 [median, mmol/L]) and cumulative RC (cumRC) (≥4.20 vs. <4.20 [median, mmol/L]): low cumTG and low cumRC, high cumTG and low cumRC, low cumTG and high cumRC, and high cumTG and high cumRC. Cox models were used to calculate the hazard ratio (HR) and 95% confidence intervals (CI) between the cumulative burden and CVD risk. During a median follow‐up of 15.97 years, 1415 participants developed CVD. After multivariable adjustment, compared to the low cumTG/low cumRC group, CVD risk was higher in the high cumTG/high cumRC (HR 1.43, 95% CI 1.24‒1.64) and low cumTG/high cumRC groups (HR 1.24, 95% CI 1.05–1.47), but not in the high cumTG/low cumRC group (HR 1.06, 95% CI 0.89–1.25). In hypertensive patients with target LDL‐C levels, high cumRC, rather than cumTG, is associated with an increased risk of CVD. Trial Registration: ChiCTR‐TNC‐11001489https://doi.org/10.1111/jch.70084cumulative exposurehypertensionremnant cholesteroltriglycerides
spellingShingle Shuang Guo
Chi Wang
Taoyu Hu
Lihua Lan
Zhen Ge
Jianxiang Huang
Shuohua Chen
Shouling Wu
Hao Xue
Association of Cumulative Exposure to Triglyceride and Remnant Cholesterol With the Risk of Cardiovascular Disease in Hypertensive Patients With Target LDL‐C
The Journal of Clinical Hypertension
cumulative exposure
hypertension
remnant cholesterol
triglycerides
title Association of Cumulative Exposure to Triglyceride and Remnant Cholesterol With the Risk of Cardiovascular Disease in Hypertensive Patients With Target LDL‐C
title_full Association of Cumulative Exposure to Triglyceride and Remnant Cholesterol With the Risk of Cardiovascular Disease in Hypertensive Patients With Target LDL‐C
title_fullStr Association of Cumulative Exposure to Triglyceride and Remnant Cholesterol With the Risk of Cardiovascular Disease in Hypertensive Patients With Target LDL‐C
title_full_unstemmed Association of Cumulative Exposure to Triglyceride and Remnant Cholesterol With the Risk of Cardiovascular Disease in Hypertensive Patients With Target LDL‐C
title_short Association of Cumulative Exposure to Triglyceride and Remnant Cholesterol With the Risk of Cardiovascular Disease in Hypertensive Patients With Target LDL‐C
title_sort association of cumulative exposure to triglyceride and remnant cholesterol with the risk of cardiovascular disease in hypertensive patients with target ldl c
topic cumulative exposure
hypertension
remnant cholesterol
triglycerides
url https://doi.org/10.1111/jch.70084
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