NON-HDL-C: THE MISSING PARAMETER IN HYPERTENSION ASSESSMENT

Objective: Non-HDL-C value, considered as a residual risk factor predictor of ASCVD in high risk and/or statin treated patients, today is gaining relevance as a risk factor. Despite of this Hypertension Guidelines do no recommended in the evaluation of hypertension. The objective of the present is to assess the prevalence of elevated values of non-HDL-C in non-diabetic hypertensives from a general population and the risk to develop new diagnosis of hypertension during a 5-year follow-up.Design and method: From an EHR, total population 820,318 subjects with at least two measurements of lipids between 2012 and 2016 in the absence of lipid lowering drugs were included. Values of total cholesterol (TC), HDL-C and LDL-C were obtained and non-HDL-C and LDL-C+30 were calculated. Individuals with non-HDL-C elevated was defined if superior to the LDL-C plus 30 mg in two consecutive occasions. Triglycerides were also measured at the same time that the calculated non-HDL-C. Subjects with non-HDL-C elevated and the same number of controls (selected with a propensity score match) were followed during six years of study period with evaluation of new diagnostic of hypertension and a multivariant Cox model were performed. Results: The general characteristics of the study population at baseline are shown in Table. Among 820,318 subjects of general population in the absence of lipid lowering treatment, 10% of them had elevated non-HDL-C, in at least the two-lipid assessment. From the total population, 101,939 have non-HDL-C elevated, 41.5% with hypertension as compare with 25,0% in the control group. During follow-up, a Cox model including age, sex, triglycerides, LDL-C and non-HDL-C demonstrated that non-HDL-C elevated increases de risk for a new diagnostic of hypertension (HR 1.365; 95CI 1.286-1.450). Conclusions: non-HDL-C elevated is frequent in hypertensive patients and it is an independent risk factor for the prevalence of hypertension. It should be included in the lab panel during the assessment of hypertension.