Abstract
BACKGROUND: High blood pressure is a major risk factor for cardiovascular and renal diseases, and lipid metabolism disorders may affect blood pressure through mechanisms such as endothelial inflammation. Remnant cholesterol, a key component of triglyceride-rich lipoproteins, has been recognized as a causal factor for atherosclerosis and metabolic disorders. This study aims to investigate the relationship of remnant cholesterol with blood pressure control in the general US population. METHODS: A total of 3915 participants with self-reported hypertension from NHANES from 2007 to 2018 were included in this study. Demographic and behavior parameters, blood pressure, and blood samples were conducted. Remnant cholesterol was estimated as total cholesterol minus low-density lipoprotein cholesterol minus high-density lipoprotein cholesterol. Control of hypertension was defined as systolic blood pressure less than 140 mmHg and diastolic blood pressure less than 90 mmHg in participants with hypertension. RESULTS: The mean age was 56.98 ± 0.28 years, and 2021 (weighted percentage 51.34%) were female. Among all participants, 2650 participants had their blood pressure well controlled. In multivariate logistic regression, the associations between remnant cholesterol and blood pressure control were statistically significant after adjusting age, sex, race/ethnicity, education level, poverty income ratio, smoking and drinking status, metabolic equivalent, HbA1c, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (Model 1: OR=0.74, 95% CI: 0.57-0.95; Model 2: OR=0.72, 95% CI: 0.55-0.94; Model 3: OR=0.73, 95% CI: 0.56-0.93; Model 4: OR=0.60, 95% CI: 0.46-0.78). The subgroup analysis revealed generally consistent associations with the main results. CONCLUSION: Remnant cholesterol is associated with blood pressure control. Targeting remnant cholesterol through lifestyle modifications or lipid-lowering therapies may improve blood pressure control in high-risk patients.