Abstract
Background: although high-density lipoprotein has cardioprotective effects, the association between serum high-density lipoprotein cholesterol (HDL-C) and hypertension is poorly understood. Therefore, we investigated whether high and low concentrations of HDL-C are associated with high blood pressure (HBP) using a large healthcare dataset. Methods: in a community-based cross-sectional study of 1,493,152 Japanese people (830,669 men and 662,483 women) aged 40–74 years who underwent a health checkup, blood pressures automatically measured at healthcare center were investigated in nine HDL-C groups (20–110 mg/dL or over). Results: crude U-shaped relationship were observed between the nine HDL-C and blood pressures in both men and women. Logistic regression analysis showed left-to-right inverted J-shaped relationships between HDL-C and odds ratios for HBP (≥140/90 mmHg and/or pharmacotherapy), with lower limits of 90–99 mg/dL in both sexes, which were unchanged after adjusting for confounding factors. However, further adjustment for body mass index and serum triglyceride concentration revealed positive linear associations between HDL-C and HBP, although blunt U-shaped associations remained in nonalcohol drinkers. Conclusion: both low and extremely high HDL-C concentrations are associated with HBP. The former association might be dependent on excess fat mass concomitant with low HDL-C, whereas the latter association may be largely dependent on frequent alcohol consumption.
Highlights
High-density lipoprotein (HDL) is considered to have cardioprotective effects, which were confirmed repeatedly in molecular, cellular, animal, and human studies [1,2,3,4,5]
Individuals with a high serum HDL cholesterol (HDL-C) concentration are considered to be at a lower risk of cardiovascular disease (CVD) and mortality according to the concepts of “the higher, the better” and “longevity syndrome” [2,6,7]
We investigated the association between HDL-C concentrations and pharmacotherapy for hypertension, which was diagnosed considering home blood pressure independently of current blood pressure measured at the checkup
Summary
High-density lipoprotein (HDL) is considered to have cardioprotective effects, which were confirmed repeatedly in molecular, cellular, animal, and human studies [1,2,3,4,5]. Increasing HDL-C with pharmacotherapy, including cholesteryl ester transfer protein (CETP) inhibitors, did not show protective effects against CVD and mortality [15,16,17,18]. Among the plausible causes of adverse reactions with CETP inhibitors (torcetrapib and evacetrapib), a slight increase in blood pressure [19,20] and vasoactive effects [21] were observed and possibly were considered as markers of profound adverse reactions due to neuroendocrine or vasomotor effects [15]. To date, the fundamental relationship between serum HDL-C concentration and blood pressure was poorly argued, probably because an inverse relationship was observed between serum
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