Background In inflammatory disorders, highest incidence of cardiovascular (CV) events paradoxically occurs at lower lipid levels (1), especially in the case of high-density lipoprotein cholesterol (HDLc). Current data in general, non-inflammatory population suggest a similar but milder phenomenon (2). Serum uric acid (SUA) levels appear to determine the inflammatory status of the subjects, even in normouricemia (3).
Objectives To assess whether inflammatory status and SUA levels associate with HDLc levels in a hypertensive population aged 65 years or older.
Methods Retrospective analysis of the FAPRES study (cross-sectional study aimed at determining the prevalence of atrial fibrillation in hypertensive patients aged 65 years or older). Inflammatory status was considered based on serum leukocytes levels. A comparison between serum lipids levels (HDLc, low-density lipoprotein-cholesterol [LDL], total cholesterol [TCh], triglycerides [TG]) and different tertiles of leukocytes and SUA has been performed using ANOVA. In case of statistically significant differences, a multivariate linear regression model was built for each lipid parameter in order to adjust for potential confounders.
Results A total of 1,003 patients were recruited, mean aged 72.9 years (SD±5.8), 52.5% females. In the sample median (±SD) leukocytes, SUA and HDLc were 6,719.6/mm3 (±1773.1), 5.2 mg/dL (±1.1), and 52.8 mg/dL (±13.1), respectively. Table shows the distribution of lipids across leukocytes and SUA tertiles: lower HDLc and higher TG levels were found in upper tertiles of both leukocytes and SUA, with no differences on TCh and LDLc. After adjusting for potential confounder (age, gender, CV risk factors, renal failure, body mass index, use of diuretics or statins), an independent, inverse association of both leukocytes (β=-0.001, p=0.02) and SUA (β=-1.054, p=0.03) with HDLc levels was confirmed. For TG levels, an independent, direct association with SUA (β=8.254, p=0.004) was also found, as well as a trend for leukocytes (β=0.003, p=0.06).
Conclusions In a non-rheumatic, hypertensive population aged 65 years or older, both inflammatory status and SUA levels showed an inverse, independent association with HDLc, following current data on patients with inflammatory disorders. This phenomenon might help to define a pro-atherogenic profile on the general population.
Ann Rheum Dis 2011;70:482.
Eur Heart J 2006;27:1174.
Disclosure of Interest None declared