title: Use of the plasma triglyceride/high-density lipoprotein cholesterol ratio to identify cardiovascular disease in hypertensive subjects.
abstract: This analysis evaluated the hypothesis that the plasma triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) concentration ratio can help identify patients with essential hypertension who are insulin-resistant, with the cardiovascular disease (CVD) risk profile associated with that defect. Data from a community-based study developed between 2003 and 2012 were used to compare CVD risk factors and outcome. Plasma TG/HDL-C cut-points of 2.5 (women) and 3.5 (men) subdivided normotensive (n = 574) and hypertensive (n = 373) subjects into "high" and "low" risk groups. Metabolic syndrome criteria (MetS) were also used to identify "high" and "low" risk groups. The baseline cardio-metabolic profile was significantly more adverse in 2003 in "high" risk subgroups, irrespective of BP classification or definition of risk (TG/HDL-C ratio vs. MetS criteria). Crude incidence of combined CVD events increased across risk groups, ranging from 1.9 in normotensive-low TG/HDL-C subjects to 19.9 in hypertensive-high TG/HDL-C ratio individuals (P for trends <.001). Adjusted hazard ratios for CVD events also increased with both hypertension and TG/HDL-C. Comparable findings were seen when CVD outcome was predicted by MetS criteria. The TG/HDL-C concentration ratio and the MetS criteria identify to a comparable degree hypertensive subjects who are at greatest cardio-metabolic risk and develop significantly more CVD.
authors.affiliation: Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina; Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina. Electronic address: salazarlandea@gmail.com.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Salazar
authors.affiliation: Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina.
authors.forename: Horacio A
authors.initials: HA
authors.lastname: Carbajal
authors.affiliation: Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina; Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina.
authors.forename: Walter G
authors.initials: WG
authors.lastname: Espeche
authors.affiliation: Hospital Municipal de Rauch, Buenos Aires, Argentina.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Aizpurúa
authors.affiliation: Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina; Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Leiva Sisnieguez
authors.affiliation: Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina; Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina.
authors.forename: Betty C
authors.initials: BC
authors.lastname: Leiva Sisnieguez
authors.affiliation: Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina; Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: March
authors.affiliation: Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina; Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina.
authors.forename: Rodolfo N
authors.initials: RN
authors.lastname: Stavile
authors.affiliation: Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Balbín
authors.affiliation: Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Reaven
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008076:Cholesterol, HDL / Q000097:blood*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: Cardiovascular outcome; TG/HDL-C ratio; hypertension; metabolic syndrome