Association of Serum High-Density Lipoprotein Cholesterol with High Blood Pressures at Checkup: Results of Kanagawa Investigation of Total Checkup Data from the National Database-9 (KITCHEN-9)

Kei Nakajima; Manami Igata; Ryoko Higuchi; Kotone Tanaka; Kaori Mizusawa; Teiji Nakamura

doi:10.3390/jcm10215118

Association of Serum High-Density Lipoprotein Cholesterol with High Blood Pressures at Checkup: Results of Kanagawa Investigation of Total Checkup Data from the National Database-9 (KITCHEN-9)

J Clin Med. 2021 Oct 30;10(21):5118. doi: 10.3390/jcm10215118.

Authors

Kei Nakajima^{1

2}, Manami Igata¹, Ryoko Higuchi¹, Kotone Tanaka¹, Kaori Mizusawa¹, Teiji Nakamura¹

Affiliations

¹ School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka 238-8522, Japan.
² Saitama Medical Center, Department of Endocrinology and Diabetes, Saitama Medical University, 1981 Kamoda, Kawagoe 350-8550, Japan.

Abstract

Background: although high-density lipoprotein has cardioprotective effects, the association between serum high-density lipoprotein cholesterol (HDL-C) and hypertension is poorly understood. Therefore, we investigated whether high and low concentrations of HDL-C are associated with high blood pressure (HBP) using a large healthcare dataset.

Methods: in a community-based cross-sectional study of 1,493,152 Japanese people (830,669 men and 662,483 women) aged 40-74 years who underwent a health checkup, blood pressures automatically measured at healthcare center were investigated in nine HDL-C groups (20-110 mg/dL or over).

Results: crude U-shaped relationship were observed between the nine HDL-C and blood pressures in both men and women. Logistic regression analysis showed left-to-right inverted J-shaped relationships between HDL-C and odds ratios for HBP (≥140/90 mmHg and/or pharmacotherapy), with lower limits of 90-99 mg/dL in both sexes, which were unchanged after adjusting for confounding factors. However, further adjustment for body mass index and serum triglyceride concentration revealed positive linear associations between HDL-C and HBP, although blunt U-shaped associations remained in nonalcohol drinkers.

Conclusion: both low and extremely high HDL-C concentrations are associated with HBP. The former association might be dependent on excess fat mass concomitant with low HDL-C, whereas the latter association may be largely dependent on frequent alcohol consumption.

Keywords: big data; blood pressure; body mass index; extremely high high-density lipoprotein cholesterol; high-density lipoprotein cholesterol; hypertension; low high-density lipoprotein cholesterol.