Abstract
On the basis of 45,092 participants (mean age of 54.04 ± 13.09 years) from the Kailuan study, this study was performed to explore the relationships among total cholesterol (TC), brachial-ankle pulse wave velocity (BaPWV), and systolic blood pressure (SBP) and quantify their separate effects. The correlations among TC, SBP, and BaPWV were analyzed using multivariate linear regression models. Mediation analysis was performed to determine whether the effect of TC on SBP can be explained by arterial stiffness. Multivariate linear regression analysis showed that for every one standard deviation increase in TC and BaPWV, SBP increased by 0.33 mmHg and 0.044 mmHg, respectively; for every one standard deviation increase in TC, BaPWV increased by 5.34 cm/s. Mediation analysis showed that the TC-induced SBP elevation was mediated by arterial stiffness in more than half of the whole cohort (indirect effect, 0.73; percent mediated, 54.5%). Furthermore, the TC-induced SBP elevation was mediated by arterial stiffness in less than half of the males (indirect effect, 0.70; percent mediated, 47.9%); however, the results were not statistically significant in females. In conclusion, TC and BaPWV are positively correlated with SBP, whereas TC is positively correlated with BaPWV. Almost half of the increase in SBP contributed to TC is mediated by arterial stiffness.
Highlights
On the basis of 45,092 participants from the Kailuan study, this study was performed to explore the relationships among total cholesterol (TC), brachial-ankle pulse wave velocity (BaPWV), and systolic blood pressure (SBP) and quantify their separate effects
TC still caused an increase in SBP in the females, its total effect, direct effect, and indirect effect were not statistically significant (Table 3). In this large community-based study of 45,092 participants, we found that both TC and BaPWV were significantly associated with SBP and that TC was associated with BaPWV
After the relevant variables were adjusted, SBP increased by 0.33 mmHg and 0.044 mmHg, respectively, for every one standard deviation increase in TC and BaPWV; for every one standard deviation increase in TC, BaPWV increased by 5.34 cm/s
Summary
On the basis of 45,092 participants (mean age of 54.04 ± 13.09 years) from the Kailuan study, this study was performed to explore the relationships among total cholesterol (TC), brachial-ankle pulse wave velocity (BaPWV), and systolic blood pressure (SBP) and quantify their separate effects. Borghi[6,7] and Pereira[8] found that the pathogenic effect of hypercholesterolemia on hypertension might be closely associated with the effect of a high cholesterol level on peripheral vascular tone and the role of tissue renin-angiotensin system. This hypothesis has not been tested in epidemiological studies. Our previous study[12] showed that the increase in arterial stiffness might precede the increase in blood pressure, and each 1-unit increase in BaPWV was associated with an increase of SBP by 0.09 mmHg. no study has explored whether the TC level increases the SBP by affecting BaPWV. In a large community cohort of 45,092 adults to investigate the relationships among TC, arterial stiffness, and SBP and to quantify the effect of the TC level attributed to changes in BaPWV on SBP
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