Key result
Hypertriglyceridemia linked to ~77% higher rate of major cardiovascular events in high-risk hypertension.
Why the study?
Although hypertriglyceridemia frequently occurs in hypertensive patients and may increase cardiovascular risk, the need for and manner of its reduction remain controversial.
Does hypertriglyceridemia increase the risk of cardiovascular events and specific comorbidities in very high-risk hypertensive patients on atorvastatin therapy?
Cohort (n=107)
Yes
Does hypertriglyceridemia increase the risk of cardiovascular events and specific comorbidities in very high-risk hypertensive patients on atorvastatin therapy?
Absolute Event Rate: 39.6% vs 22.4%
p-value: p=0.027
In very high-risk hypertensive patients on statin therapy, hypertriglyceridemia is associated with a significantly higher 5-year risk of cardiovascular events and new-onset diabetes.
May support triglyceride monitoring in statin-treated very high-risk hypertensives; leaves open whether lowering levels improves outcomes.
although hypertriglyceridemia (hTG) frequently occurs in hypertensive patients and may increase cardiovascular risk, the need for and manner of its reduction remain controversial.The objectives of this study were to compare lipid profiles, parameters of glucose homeostasis, comorbidity, and 5-year survival without cardiovascular events in very high-risk hypertensive (Vhrh) patients with and without hTG, who received moderate intensity atorvastatin therapy.after initial assessment, 107 Vhrh subjects were divided into two groups, i.e., without (n = 49) and with HTG (n = 58).During observation once annually patients were interviewed about prior hospitalizations with further screening for diabetes.combined endpoint included hospitalization due acute myocardial infarction, decompensated heart failure, stroke or death.Survival was analyzed by Kaplan-Meier's method.Nonparametric methods were used for statistical analysis.higher median values of logarithmic value of triglycerides-to-hdl-cholesterol ratio, lipid accumulation product, fasting insulin, and HOMA index were observed in group 2 (P<0.002) that reflect predominance of small dense ldl particles, ectopic lipid deposition and insulin resistance.Patients with hTG more commonly had type 2 diabetes (58.6% vs 34.5%, including first-detected cases during initial assessments and observation, P = 0.02), liver steatosis (81.0%vs 55.1%, P = 0.006), and lithogenic gallbladder disorders (55.2% vs 34.7%, P = 0.05).Women with HTG frequently had a history of hysterovariectomy (55.2% vs 19.0%, Р = 0.018).Despite long-term statin therapy, they often failed to reach recommended ldl-c targets and had worse survival due to significantly higher incidence of combined endpoint (39.6% vs 22.4%, P = 0.027).Further studies are necessary to find safe and effective strategy for secondary prevention in this population.K e y w o r d s: hypertriglyceridemia, very high-risk hypertensive patients, type 2 diabetes, cardiovascular events, atorvastatin therapy.
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Korolyuk et al. (2020) conducted a cohort in Very high-risk hypertension (n=107). Hypertriglyceridemia vs. Normotriglyceridemia (TG < 1.7 mmol/l) was evaluated on Combined endpoint of hospitalization due to acute myocardial infarction, decompensated heart failure, stroke, or death (p=0.027). Hypertriglyceridemia in very high-risk hypertensive patients was associated with a significantly higher 5-year incidence of cardiovascular events compared to normotriglyceridemia (39.6% vs 22.4%, P=0.027).
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