Key result
Higher NHHR linked to ~14% greater odds of depressive symptoms in hypertensive adults.
Why the study?
Lipid metabolism correlates with depressive symptoms and hypertension is a risk factor, but the association between the non-HDL to HDL cholesterol ratio and clinically significant depressive symptoms in hypertension was unclear.
Is the non-HDL cholesterol to HDL cholesterol ratio (NHHR) associated with clinically significant depressive symptoms in U.S. adults with hypertension?
Cross-Sectional (n=10,754)
Is the non-HDL cholesterol to HDL cholesterol ratio (NHHR) associated with clinically significant depressive symptoms in U.S. adults with hypertension?
Effect estimate: OR 1.14 (95% CI 1.09-1.19)
p-value: p=<0.001
NHHR exhibits a U-shaped association with depressive symptoms in hypertensive adults, suggesting its potential utility as a biomarker for depression in this population.
Hypothesis-generating inverse association with depressive symptoms; leaves open causality and any clinical relevance in observational data.
Background The non-HDL cholesterol to HDL cholesterol ratio (NHHR) is an emerging and reliable lipid marker for assessing the risk of cardiovascular disease. Previous studies have demonstrated a correlation between lipid metabolism and clinically significant depressive symptoms, while also identifying hypertension as a potential risk factor for this condition. This study aims to investigate the association between NHHR and clinically significant depressive symptoms in patients diagnosed with hypertension. Methods The study was conducted over a period from 2007 to 2018, utilizing data from the National Health and Nutrition Examination Survey (NHANES). The study population comprised participants aged 18 years and older from across the United States. Depressive symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9), while NHHR values were derived from laboratory cholesterol test results. The cross-sectional analysis included a total of 10,754 participants. Various methods were employed, including multiple logistic regression, curve analysis, threshold effect modeling, and subgroup analysis, to investigate the relationship between NHHR and depressive symptoms. Results The curve-fitting model demonstrated a distinct U-shaped relationship among the variables examined. Threshold analysis indicates that a cutoff point of 1.25 exists in the association between log-transformed NHHR and clinically significant depressive symptoms. Below this threshold, NHHR was negatively correlated with the prevalence of depressive symptoms (OR = 0.19, 95% CI: 0.07–0.52, P = 0.001), whereas above the threshold, a positive correlation was observed (OR = 1.14, 95% CI: 1.09–1.19, P < 0.001). Conclusions The study findings suggest a U-shaped association between NHHR and depressive symptoms in adults with hypertension in the United States. NHHR appears to serve as a succinct indicator of depressive symptoms in individuals aged 18 and older with hypertension. Consequently, further exploration into the correlated factor NHHR may offer an innovative perspective for research on depressive symptoms among this population.
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Lu et al. (2026) conducted a cross-sectional in Hypertension and depressive symptoms (n=10,754). Non-HDL cholesterol to HDL cholesterol ratio (NHHR) was evaluated on Clinically significant depressive symptoms (PHQ-9 score ≥ 10) (OR 1.14, 95% CI 1.09-1.19, p=<0.001). In U.S. adults with hypertension, log-transformed NHHR above 1.25 was positively associated with depressive symptoms (OR 1.14), while values below 1.25 were negatively associated (OR 0.19).
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