Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and hypertension in Chinese elderly

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a novel lipid marker for cardiovascular disease. While previous studies have suggested a link between dyslipidemia and hypertension in various populations, the association between NHHR and hypertension in the older Chinese population remains unclear. This study aimed to investigate the association between NHHR and hypertension in a middle-aged and older Chinese population using data from the China Health and Retirement Longitudinal Study (CHARLS). We conducted a cross-sectional study using data from the China Health and Retirement Longitudinal Study 2015 database. NHHR was calculated as the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol. Multivariable logistic regression models and penalized spline analysis were employed to investigate the association between NHHR and hypertension. Additionally, subgroup and sensitivity analyses were performed to assess the robustness of the findings. A total of 8342 participants (median age 67 years [interquartile range = 63–72]; 49.6% male, 50.4% female) were included in the analysis. NHHR was positively associated with prevalent hypertension. In the continuous analysis, the odds ratio for hypertension increased with each unit increment in NHHR across all multivariable-adjusted models. In the categorical model, the P value for the trend in the fully adjusted model was .097. A penalized spline analysis revealed a nonlinear association between NHHR and hypertension ( P < .001). The association remained robust in subgroup and sensitivity analyses. This study found a significant association between NHHR and hypertension among older Chinese adults. The nonlinear relationship suggests a complex interplay that warrants further investigation. Prospective studies are needed to confirm these findings and clarify the temporal relationship between NHHR and hypertension.