Use of the plasma triglyceride/high-density lipoprotein cholesterol ratio to identify cardiovascular disease in hypertensive subjects

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.