April 4, 2025BMC Cardiovascular DisordersOpen Access

Association between TG/HDL-C and hypertension in Chinese middle-aged and older adults: findings from CHARLS

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Why the study?

The TG/HDL-C ratio is a recognized risk factor for cardiovascular diseases, insulin resistance, and metabolic syndrome, but its relationship with hypertension in Chinese middle-aged and elderly populations needed investigation.

Does a higher TG/HDL-C ratio associate with an increased risk of hypertension in Chinese middle-aged and older adults?

Structured PICO

Does a higher TG/HDL-C ratio associate with an increased risk of hypertension in Chinese middle-aged and older adults?

Population

12,824 Chinese middle-aged and older adults (aged ≥45 years) from the CHARLS database (2011-2018). Excluded if missing data on TG/HDL-C or hypertension record, or taking lipid-lowering medication.

Intervention

Higher TG/HDL-C ratio

Comparator

Lower TG/HDL-C ratio

Outcome

Prevalence and incidence of hypertension (identified by self-report or taking anti-hypertensive medications)

A higher TG/HDL-C ratio is significantly associated with an increased prevalence and incidence of hypertension in Chinese middle-aged and older adults.

Implication

TG/HDL-C was associated with hypertension prevalence and incidence; leaves open whether it refines risk prediction beyond established factors.

Abstract

BACKGROUND: The triacylglycerol to high-density lipoprotein cholesterol ratio (TG/HDL-C) has been recognized as one of the risk factors for cardiovascular diseases, insulin resistance and metabolic syndrome. We aimed to investigate the relationship between TG/HDL-C and hypertension in a Chinese middle-aged and elderly population. METHODS: We used data from the CHARLS database 2011-2018 to explore the relationship between TG/HDL-C and hypertension through cross-sectional and longitudinal studies. Hypertension was identified by self-report or taking anti-hypertensive medications. Participants aged below 45, or with missing data on TG/HDL-C or hypertension record, or taking lipid-lowering medication were excluded. Participants were divided into three or two groups based on triplets TG/HDL-C and median TG/HDL-C in cross-sectional and longitudinal analysis. Multivariate logistic regression analysis, subgroup analysis, and restricted cubic splines were used in statistics. RESULTS: In the cross-sectional analysis, a total of 12,824 participants were included, after adjusting for potential confounders, there was a significant association between higher TG/HDL-C and increased prevalence of hypertension (OR = 1.86, 95% CI: 1.65-2.09, p < 0.001), systolic blood pressure (SBP) above 140 mmHg (OR = 1.37, 95% CI: 1.25-1.50, p < 0.0001), diastolic blood pressure (DBP) above 90 mmHg (OR = 1.47, 95% CI: 1.29-1.67, p < 0.0001), and pulse pressure (PP) above 60 mmHg (OR = 1.17, 95% CI: 1.07-1.29, p < 0.0011). The longitudinal analysis included 7909 participants, there was a significant association between higher TG/HDL-C and increased incidence of hypertension (OR = 1.51, 95% CI: 1.32-1.73,p < 0.001). Restricted cubic splines show nonlinear relationship between TG/HDL-C and hypertension. CONCLUSION: These results demonstrated significant positive association between TG/HDL-C and the prevalence & incidence of hypertension, in a nationwide representative middle-aged and elderly population in China.