Hypertriglyceridemia is associated with long-term risk of cardiovascular events and specific comorbidity in very high-risk hypertensive patients

Abstract

Although hypertriglyceridemia (HTG) frequently occurs in hypertensive patients and may increase cardiovascular risk, the need and way of its reduction remain controversial. The objectives of the research was to compare lipid profiles, parameters of glucose homeostasis, comorbidity, a 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 interviewing 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 composite endpoint (39.6% vs 22.4%, P=0.027). Further researches are necessary to find safe and effective strategy for secondary prevention in this population.