Key result
Each one-unit increase in LDL/HDL ratio is linked to ~22% higher hypertension prevalence.
Why the study?
The relationship between low-density lipoprotein/high-density lipoprotein ratio (LHR) and the prevalence and incidence of hypertension had not been reported in large populations.
Does an elevated LDL/HDL ratio increase the prevalence and incidence of hypertension in middle-aged and older adults?
Observational (n=13,150)
Yes
Does an elevated LDL/HDL ratio increase the prevalence and incidence of hypertension in middle-aged and older adults?
An elevated LDL/HDL ratio is independently associated with a higher prevalence and incidence of hypertension in middle-aged and older Chinese adults, suggesting its utility as a predictive biomarker for hypertension risk.
Answers are grounded in this paper and cite their sources.
May inform hypertension risk stratification in middle-aged Chinese adults; hypothesis-generating and requires validation before clinical adoption.
Introduction Hypertension is a global public health issue and major risk factor for cardiovascular disease (CVD). Low-density lipoprotein/high-density lipoprotein ratio (LDL/HDL Ratio, LHR) is an important indicator of lipid metabolism related to CVD. However, the relationship between LHR and the prevalence and incidence of hypertension has not been reported in large populations. This study aims to investigate the association between LHR and hypertension in middle-aged and elderly population. Methods This study utilized the China Health and Retirement Longitudinal Study (CHARLS) database from 2011 to 2020. Cross-sectional study was employed to analyze the association between LHR and the prevalence of hypertension; longitudinal analysis was used to examine the association between LHR and the incidence of hypertension. Eligible participants were adults aged 45 years and older with complete LHR and self-reported hypertension records. Multivariate logistic regression, smooth curve fitting, threshold effect analysis was performed. Results In the cross-sectional study, we included 13,150 participants. After adjusting for potential confounders, each one-unit increase in LHR was associated with a 22% increase in the prevalence of hypertension (OR = 1.22, 95% CI: 1.15-1.30, P < 0.0001). The association between LHR and hypertension was consistent across different subgroups, with higher LHR being more strongly associated with increased hypertension prevalence in females and non-smokers. Our results revealed a linear relationship between LHR and hypertension prevalence. Longitudinal analysis showed that, among participants without hypertension in 2011, after 7 years of follow-up, the association between LHR and hypertension incidence remained robust after adjusting for a wide range of demographic, clinical, and biochemical variables ( P < 0.05). Conclusions These results demonstrated significant positive association between LHR and the prevalence & incidence of hypertension, in a nationwide representative middle-aged and elderly population in China.
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Lai et al. (2025) conducted an observational in Hypertension (n=13,150). LDL/HDL ratio vs. Lower LDL/HDL ratio was evaluated on Prevalence of hypertension (OR 1.22, 95% CI 1.15-1.30, p=<0.0001). Each one-unit increase in the LDL/HDL ratio was associated with a 22% increase in the prevalence of hypertension (OR 1.22) among middle-aged and older Chinese adults.
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