Abstract 5000: A Prospective Examination of the Association of Nuclear Magnetic Resonance Measured Lipoprotein Particles with Incident Hypertension in the Women’s Health Study
Background: While standard cholesterol fractions have been modestly associated with incident hypertension, the relationship of incident hypertension with alternate lipoprotein measures, which may add etiologic information, is unclear and understudied.
Methods and Results: Baseline lipoprotein particle concentrations of high-, low-, and very-low-density lipoproteins (HDLNMR, LDLNMR, and VLDLNMR) were measured by nuclear magnetic resonance (NMR) in a prospective cohort of 18,806 initially healthy non-hypertensive women. During a median of 9.8 years of follow-up, 5,640 cases of incident hypertension were reported. Adjusting for age, body mass index, exercise, alcohol intake, history of diabetes, cholesterol treatment, duration of fasting, menopause, and hormone use (Table⇓), the concentrations of small HDLNMR and small LDLNMR particles were associated with an increased risk of hypertension; hazard ratios (HRs) and 95% CIs for top vs bottom quintiles were 1.33 (1.23–1.45) and 1.58 (1.44–1.72) respectively. Conversely, the concentrations of large HDLNMR and large LDLNMR particles were associated with decreased risk of hypertension; HRs and 95% CIs for top vs bottom quintiles were 0.78 (0.73– 0.87) and 0.84 (0.77– 0.91) respectively. VLDLNMR followed a different pattern, with top vs bottom concentrations of large particles associated with an increased risk of hypertension, HR 1.53 (1.41–1.67), while small VLDLNMR particles showed a trend towards increased risk (P trend = 0.03). Further adjustment for baseline blood pressure attenuated the observed associations, but each significant linear trend across quintiles persisted except for small VLDLNMR.
Conclusion: Baseline NMR-measured lipoprotein particles were associated with incident hypertension in women, and remained significant after adjustment for standard risk factors, including baseline blood pressure. Differences in the associations by size were observed for each lipoprotein particle.