| Title: | Differences in HDL-related mortality risk between individuals with and without hypertension: a prospective cohort study in UK Biobank. |
| Journal: | European Journal of Preventive Cardiology |
| Published: | 21 Feb 2023 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/36802288/ |
| DOI: | https://doi.org/10.1093/eurjpc/zwad053 |
Publication 7931
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Abstract
BACKGROUND AND AIMS: Very high levels of high-density lipoprotein cholesterol (HDL-C) have been paradoxically linked to increased mortality risk. The present study aimed to examine associations of HDL-C and varied sizes of the HDL particle (HDL-P) with mortality risk stratified by hypertension. METHODS AND RESULTS: This prospective cohort study included 429 792 participants (244 866 with hypertension and 184 926 without hypertension) from the UK Biobank. During a median follow-up of 12.7 years, 23 993 (9.8%) and 8142 (4.4%) deaths occurred among individuals with and without hypertension, respectively. A U-shaped association of HDL-C with all-cause mortality was observed in individuals with hypertension after multivariable adjustment, whereas an L-shape was observed in individuals without hypertension. Compared with individuals with normal HDL-C of 50-70 mg/dL, those with very high HDL-C levels (>90 mg/dL) had a significantly higher risk of all-cause mortality among individuals with hypertension (hazard ratio, 1.47; 95% confidence interval, 1.35-1.61), but not among those without hypertension (1.05, 0.91-1.22). As for HDL-P, among individuals with hypertension, a larger size of HDL-P was positively whereas smaller HDL-P was negatively associated with all-cause mortality. After additional adjustment for larger HDL-P in the model, the U-shaped association between HDL-C and mortality risk was altered to an L-shape among individuals with hypertension. CONCLUSIONS: The increased risk of mortality associated with very high HDL-C existed only in individuals with hypertension, but not in those without hypertension. Moreover, the increased risk at high HDL-C levels in hypertension was likely driven by larger HDL-P.14 Authors
- Jun-Xiang Chen
- Rui Li
- Tingting Geng
- Yuexuan Wang
- Qi Lu
- Zhou-Zheng Tu
- Yue Li
- Yun-Fei Liao
- Kun Yang
- Li-Rong Zhou
- Wen-Wei Tong
- Yan-Feng Zhou
- Gang Liu
- An Pan
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