Body Mass Index and LDL Cholesterol Across Controls, Hypertension, and Ischemic Heart Disease with Preserved Ejection Fraction: A Single-Center Retrospective Cross-Sectional Study

Background/Objectives: We compared BMI and LDL-C across database-defined reference controls, hypertension, and preserved-EF ischemic heart disease without assuming HFpEF. Methods: This single-center retrospective cross-sectional study included 128 adults (20 controls, 46 with hypertension, and 62 in the preserved-EF ischemic group). Analyses included nonparametric tests, multinomial regression, clinical-group models with and without statin adjustment, and a post hoc common-age sensitivity analysis. Results: Median BMI was 25.89, 28.25, and 29.00 kg/m2, respectively (p < 0.001); median LDL-C was 86.0, 109.5, and 100.0 mg/dL (p = 0.055), alongside statin use of 0%, 50.0%, and 87.1%. Per 5 kg/m2 higher BMI, the adjusted RRR for preserved-EF ischemic versus control status was 3.94 (95% CI 1.60–9.71; p = 0.003) and remained 3.48 (95% CI 1.35–8.97; p = 0.010) among participants aged 40–68 years. In clinical-group models, BMI estimates were similar without and with statin adjustment (OR 1.76 and 1.89); LDL-C was not independently associated with preserved-EF ischemic status. Conclusions: BMI differed more consistently across groups than treated, contemporaneous LDL-C. These associations are imprecise and describe group status; they do not establish causation, progression, prospective HF risk, or HFpEF.