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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Lipids in Cardiovascular Disease
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1469848
This article is part of the Research Topic Evidence of Atherogenic Lipoproteins: what we gain from in vitro and in vivo research View all 9 articles

A Non-Linear Association of Low-density lipoprotein cholesterol with All-Cause and Cardiovascular Mortality Among Patients with Hypertension

Provisionally accepted
Guoliang Liang Guoliang Liang Wenhao Zhang Wenhao Zhang Xinxin Gu Xinxin Gu Qiong Zhang Qiong Zhang Ankang Liu Ankang Liu Xinran Qing Xinran Qing Jiangwei Ma Jiangwei Ma *
  • Department of Cardiovascular Medicine, Anhui University of Science and Technology Affiliated Fengxian Hospital, 6600 Nanfeng Road, Fengxian, Shanghai 201499, P.R. China, Shanghai, China

The final, formatted version of the article will be published soon.

    Background: Although 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. Methods: Hypertensive participants aged ≥18 years old from the National Health and Nutrition Examination Survey (NHANES) 1999–2018 with blood lipid testing data and complete follow-up data until December 31, 2019 were enrolled in the analysis. Univariate and multivariate Cox regression were conducted for the calculation of hazard ratios (HR) and 95% confidence intervals (CIs). A restricted cubic spline (RCS) curve was performed to visually represent the relationship between LDL-C and mortality. Survival analysis of Kaplan-Meier and stratification analysis were also carried out. Results: We finally analysed a cohort of 9,635 participants (49.6% male, mean age of 59.4 years). Following a median of 98 months of follow-up, 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 lower levels of LDL-C groups had 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 has been completely adjusted. Both all-cause mortality and cardiovascular mortality showed a non-linear association with LDL-C concentration in restricted cubic spline regression analysis. Conclusions: In individuals with hypertension, LDL-C was linked to cardiovascular and all-cause mortality, and we further demonstrated that this relationship was non-linear.

    Keywords: Low-density lipoprotein cholesterol, All-cause mortality, Cardiovascular mortality, Hypertension, NHANES

    Received: 24 Jul 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 Liang, Zhang, Gu, Zhang, Liu, Qing and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jiangwei Ma, Department of Cardiovascular Medicine, Anhui University of Science and Technology Affiliated Fengxian Hospital, 6600 Nanfeng Road, Fengxian, Shanghai 201499, P.R. China, Shanghai, China

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