PULSE WAVE VELOCITY PROGRESSION DETERMINANTS: NO SIGNIFICANT ASSOCIATION WITH NOVEL LIPID PARAMETERS

Objective: Lipid profiles, including both traditional and novel parameters, have been linked to arterial stiffness (pulse wave velocity-PWV) over time. This study aimed to evaluate the relationship between standard and emerging lipid parameters (e.g., non-HDL/HDL, LDL/HDL, total cholesterol/HDL, Log TG/HDL, and the triglyceride-glucose index [TyG]) and changes in PWV (δPWV) during a 3.8 years of follow-up among hypertensive patients. Design and method: We included 469 hypertensive outpatients aged 18-80 years from the Hypertension Unit of our hospital, recruited from September 2006 to October 2010. PWV was measured at baseline and after a mean follow-up of 3.8 years (I-III quartiles: 3.5 – 4.2 years). Changes in PWV (δPWV) between baseline and follow-up were then calculated, and the population was divided accordingly to the best predictive values for CV outcomes (0.5 m/s). Results: The study cohort was 58.4% male, with a mean age of 53.6±12.9 years. Baseline fasting glucose, total cholesterol, HDL, LDL, and triglycerides averaged 89.1±21.4, 198.0±34.7, 53.0±13.5, 120.2±31.5, and 123.4±72.6 (all mg/dL), respectively. PWV significantly increased from baseline to follow-up (8.6±2.1 vs 9.2±2.3 m/s; p=0.0001), with 51.6% of patients exhibiting a δPWV>=0.5 m/s. Patients with δPWV >= 0.5 m/s had a significantly lower baseline PWV (8.0±1.5 vs 9.2±2.3 m/s) and HDL (51.5±13.5 vs 54.7±13.3 mg/dL) with higher LDL/HDL ratio (2.46±0.89 vs 2.30±0.86), non-HDL/HDL ratio (3.0±1.1 vs 2.8±1.1), total cholesterol/HDL ratio (4.0±1.1 vs 3.8±1.1), and logTG/HDL (0.043±0.015 vs 0.040±0.014, p<0.05 for all comparison). However, no significant univariate association was observed between lipid parameters and baseline PWV, analysed either as a continuous or dichotomous variable (PWV>10 m/s). Univariate analysis found a modest correlation between δPWV and δPWV>=0.5 and logTG/HDL (r=0.121, p=0.009 and r=0.094, p=0.042, respectively) but did not persist at multivariate analysis adjusted for age, sex, δSBP, ACE inhibitor or ARB use, lipid-lowering therapy, diabetes, and GFR. Conclusions: This study found no significant associations between emerging lipid parameters and PWV, assessed either as a continuous or dichotomous variable. Age and blood pressure values remain the main determinants of PWV and its changes over time.