Abstract Body: Background: Early-onset hypertension is associated with greater risk of cardiovascular mortality and hypertension associated organ damage, compared to late-onset hypertension. Non-high-density lipoprotein cholesterol (non-HDL-C) is known to better predict future cardiovascular event risk, compared to low-density lipoprotein cholesterol. Whether higher long-term non-HDL-C variability from childhood is associated with higher risk of early-onset hypertension is unclear.
Methods: We included 1271 participants of the Bogalusa Heart Study (age at enrollment: 9.9 ± 4.0 years, follow-up: 38.3 ± 3.8 years, age at last exam: 48.2 ± 5.2 years, 59.5 % women, 34.4 % Black participants) with ≥3 lipid measurements during follow-up. Non-HDL-C was calculated as total cholesterol (mg/dL) - HDL-C (mg/dL). Onset of hypertension was defined as having blood pressure ≥140/90 mmHg or using antihypertensive medications during follow-up. Participants were categorized according to age at hypertension onset (years) into 4 subgroups: <35 (early-onset), 35-44, ≥45, and people without hypertension. Long-term non-HDL-C variability was obtained from the deviation from age predicted values (DEV) and residual SD (RSD). DEV and RSD were calculated from growth curves derived from linear mixed effect models, as the mean and SD of the residuals of observed and predicted non-HDL-C levels. Associations between non-HDL-C variability and hypertension onset subgroups were analyzed using multinomial logistic regression models. Interactions by race and sex were performed.
Results: For 1-SD increase in DEV and RSD of non-HDL-C, the odds of hypertension increased for all hypertension onset subgroups compared to people without hypertension, after adjusting for race, sex, diabetes, obesity, and smoking status, education, and non-HDL-C at last exam. The odds of hypertension was highest in the early-onset subgroup (Table). No significant interactions were found between both DEV and RSD and race and sex.
Conclusions: Our findings suggest that individuals with higher long-term non-HDL-C variability may be at a greater risk of having early-onset hypertension.