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July 23, 2026BMC Cardiovascular DisordersOpen Access

Highest Remnant Cholesterol-Inflammation Index quartile linked to ~36% greater incident hypertension risk and increased MACE.

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Why the study?

Residual cardiovascular risk remains a significant challenge, motivating an evaluation of the Remnant Cholesterol-Inflammation Index on hypertension incidence and cardiovascular sequelae.

Does a high Remnant Cholesterol-Inflammation Index (RCII) increase the risk of incident hypertension and adverse cardiovascular outcomes in Chinese and UK populations?

Population

Participants from CHARLS (N = 8,650 and N = 5,022) and UK Biobank (273,122 hypertensive participants)

Comparison

High vs low Remnant Cholesterol-Inflammation Index levels

Design

Prospective cohort analysis

Key result

The highest quartile of the Remnant Cholesterol-Inflammation Index was associated with increased risks of incident hypertension (OR 1.364) and MACE (HR 1.273) compared to the lowest quartile.

Authors

LWLerui WangSWSiyuan WenZMZhiyi Ma

Discussion

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Overview

RCII may identify higher-risk patients for hypertension and MACE; hypothesis-generating and requires prospective validation before clinical use.

Key Points

  • This study investigates the role of the Remnant Cholesterol-Inflammation Index (RCII) in predicting hypertension and cardiovascular outcomes.
  • Analyzed data from two prospective cohorts: CHARLS and UK Biobank.
  • Utilized multivariable logistic regression and Cox proportional hazards models for outcome assessment.
  • Sample sizes included 8,650 prevalent and 5,022 incident hypertension participants in CHARLS and 273,122 in UKB.
  • Higher RCII associated with increased incident hypertension (OR, 1.346; 95% CI, 1.192-1.519).
  • Participants in the highest RCII quartile showed significantly greater risk for MACE (HR, 1.273; 95% CI, 1.232-1.315) and all-cause mortality (HR, 1.214; 95% CI, 1.169-1.261).
  • Joint-effect analysis indicated elevated remnant cholesterol and inflammation yield the highest risk of MACE (HR, 1.16; 95% CI, 1.12-1.20).

Study Design

Type

Cohort (n=286,794)

Multicenter

Yes

Structured PICO

Does a high Remnant Cholesterol-Inflammation Index (RCII) increase the risk of incident hypertension and adverse cardiovascular outcomes in Chinese and UK populations?

P
Population
286,794 participants from the CHARLS and UK Biobank cohorts evaluated for the association between the Remnant Cholesterol-Inflammation Index and incident hypertension or cardiovascular outcomes.
E
Exposure
High Remnant Cholesterol-Inflammation Index (RCII) (highest quartile)
C
Comparator
Low Remnant Cholesterol-Inflammation Index (RCII) (lowest quartile)
O
Outcome
Incident hypertension (in CHARLS) and long-term adverse outcomes including all-cause mortality, major adverse cardiovascular events (MACE), and cardiovascular death (in UKB)composite

Main Result

Odds Ratio: 1.364 (95% CI 1.15–1.618)

p-value: p=<0.001

The Remnant Cholesterol-Inflammation Index (RCII) serves as a complementary marker for residual cardiovascular risk, predicting both incident hypertension and adverse cardiovascular events in hypertensive patients.

Limitations

  • External validation and decision-utility studies are needed before clinical implementation
  • External validation needed
  • Decision-utility studies needed before clinical implementation

Cite This Study

Wang et al. (2026) conducted a cohort in Hypertension (n=286,794). Remnant Cholesterol-Inflammation Index (RCII) vs. Lowest RCII quartile was evaluated on Incident hypertension (OR 1.364, 95% CI 1.150-1.618, p=<0.001). The highest quartile of the Remnant Cholesterol-Inflammation Index was associated with increased risks of incident hypertension (OR 1.364) and MACE (HR 1.273) compared to the lowest quartile.

synapsesocial.com/papers/6a61ae6bfaa9903c51169c00https://doi.org/10.1186/s12872-026-06322-6
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