HDL CHOLESTEROL AND CARDIOVASCULAR EVENTS ON HYPERTENSIVE PATIENTS

Abstract

Objective: Evaluate cardiovascular events on hypertensive patients and their HDL-cholesterol levels Design and method: Retrospective single-center study including first visits of adult patients in a hypertension clinic of a tertiary hospital during 2015 and their follow-up until 2020. Patients without follow-up and/or information about HDL cholesterol levels were excluded. Information on demographics, comorbidities, blood pressure control (<140/90mmHg), number of drugs, and cardiovascular events were analyzed. Subjects were divided in 3 groups: Group 1 - HDL <40mg/dL; Group 2- 40-80 mg/dL and Group 3 - >80mg/dL. Results: Of the 104 initial participants we included 71, 43 female (60.6%) with mean age 55.9 years (18-87), which were monitorized on average for 42.5 months (3-60). Patients were taking on average 2.67 different anti-hypertensive drugs and, by the end of follow-up, 53 (74.6%) had controlled blood pressure. The sample included 26 (36.6%) smokers, 18 (25.3%) patients with diabetes, 9 (12.7%) with obstructive sleep apnea SAOS, 6 (8.5%) with chronic kidney disease and there were 30 (42.3%) patients with BMI > 30 HDL cholesterol mean levels were 50.98 mg/dL (24-95). Group 1 included 19 (26.8%) patients, of these 15 (78.9%) had controlled blood pressure, and 3 presented cardiovascular events during the follow-up (2 acute myocardial infarction and 1 cerebrovascular event). Within group 2 there were 47 (66.2%) patients, 36 (76.6%) with controlled blood pressure and 2 cardiovascular events occurred (acute myocardial infarction). There were no cardiovascular events on group 3, which included 5 (7%) patients, 2 of those with controlled blood pressure. Conclusions: Some studies established a U shaped risk of cardiovascular events on the lower and higher end of HDL cholesterol. The first relation is well established, however the optimal higher level of HDL cholesterol is not defined. On our study the majority of patients presented controlled blood pressure and HDL-C within target levels. There was a small number of patients with HDL cholesterol >80mg/dL and no events occurred, which is a limitation to make any conclusions. On the other hand we verified that the patients with low levels of HDL cholesterol had more events.