Association of cumulative exposure to triglyceride and remnant cholesterol with the risk of cardiovascular disease in hypertensive patients with target LDL-C
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Background
The associations of cumulative exposure to triglycerides (cumTG) and remnant cholesterol (cumRC) with cardiovascular disease (CVD) risk in patients with optimal low-density lipoprotein cholesterol (LDL-C) levels remain uncertain. We aimed to explore the relationship between cumTG and cumRC and the risk of CVD in hypertensive patients with target LDL-C.
Methods
A total of 12,086 hypertensive participants with target LDL-C level who completed three health examinations from 2006 to 2010 were enrolled and followed until December 31, 2022. The cumulative burden was derived by multiplying the average level with the interval between two consecutive assessments. The primary outcome included a composite of CVD events (myocardial infarction, ischemic stroke, and hemorrhage stroke). Participants were divided into 4 groups based on the median values of cumTG and cumRC to assess their joint associations. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence intervals (CI) between the cumulative burden and CVD risk.
Results
During a median follow-up of 11.95 years, 1,392 participants developed CVD. After multivariable adjustment, compared to the low cumTG/low cumRC group, both the high cumTG/high cumRC group (HR 1.43, 95% CI 1.24‒1.64) and the low cumTG/high cumRC group (HR 1.26, 95% CI 1.07‒1.49), but not the high cumTG/low cumRC group (HR 1.01, 95% CI 0.84‒1.20), were associated with higher risk of CVD.
Conclusions
In hypertensive patients who met the target level of LDL-C, the cumulative burden of RC was a risk factor for CVD and exhibited a stronger association with CVD risk compared to cumulative triglycerides burden.
