Remnant Cholesterol, Not Ldl Cholesterol, Is Associated With the Risk of Hypertension in the Middle-Aged and Elderly Population: Bushehr Elderly Health Cohort Publisher



Esmaeili B ; Esmaeili S ; Fahimfar N ; Rezaeitavirani M ; Razi F ; Nabipour I ; Khashayar P ; Bandarian F
Source: Frontiers in Cardiovascular Medicine Published:2025

Abstract

Background: Despite available studies, the link between dyslipidemia and hypertension remains unclear, particularly among different ethnicities, age groups, and genders. This study aimed to assess this association in the Iranian elderly population. Methods: In a cross-sectional study, we used data from phase II of the Bushehr Elderly Health Program (BEHP). Participants were divided into hypertensive and non-hypertensive groups based on their blood pressure. The association between lipid parameters and hypertension (HTN) was evaluated using multiple logistic regression analysis. Additionally, we conducted a subgroup analysis by gender, age, and BMI (Body Mass Index). Results: In this study, 1,918 people with a mean age of 62.10 ± 8.05 were included. Of them, 1,133 (59.1%) were hypertensive, and 57.2% were females (1,097). Among the lipid profiles, individuals with HTN had higher levels of triglyceride (TG) and remnant cholesterol (RC). There was a negative association between high-density lipoprotein (HDL-c) levels and high blood pressure 0.987(0.978–0.995), p:0.003, and a positive association between TG and RC ≥ 30 levels and HTN ([1.003(1.002–1.005), p < 0.001]; [1.36 (1.123–1.648), p:0.002], respectively). This positive association was observed after full adjustment for age, gender, and BMI. While HDL-C was lower and RC levels were significantly higher only in the hypertensive people aged ≤65 (p < 0.01), higher RC levels were observed in the hypertensive groups independent of BMI levels (p = 0.004). Moreover, the levels of RC ≥ 30 mg/dl were associated with the risk of HTN only in males. Conclusion: In the middle-aged and elderly hypertension population, there is a positive and statistically significant association between RC and HTN. This suggests that this indicator is associated with HTN, particularly in those with normal or subnormal levels of traditional risk factors. Moreover, this association may be affected by age and anthropometric parameters as well as life style factors. © 2025 Elsevier B.V., All rights reserved.