Earlier onset of hypertriglyceridemia increases risk of CVD and mortality: JAHA

The authors suggest that to reduce hypertriglyceridemia‐related risk of CVD and mortality, efforts to develop preventive and therapeutic strategies and more aggressive actions to identify hypertriglyceridemia earlier in life are warranted.

Considering that only limited studies have involved new‐onset hypertriglyceridemia, Shouling Wu, Department of Cardiology, Kailuan General Hospital, Tangshan, China, and colleagues aimed to investigate the associations of the onset age of hypertriglyceridemia with cardiovascular diseases and all-cause mortality in a population‐based prospective study.

The study enrolled 98 779 participants free of hypertriglyceridemia and CVD in the Kailuan study started in June 2006. All participants biennially underwent health checkups until December 2017. A total of 13 832 patients developed new hypertriglyceridemia. The researchers applied a 1:1 age‐ and sex‐matched analysis for selecting a control subject of the same year for each new‐onset case. 13 056 case‐control pairs were included in the total. The total follow‐up time was 179 409 person‐years with seven years of median follow-up. Cardiovascular disease and all-cause mortality were the primary outcomes. Estimation of hazard ratios was done after adjustment for baseline characteristics.

The study led to the following findings:

· The researchers documented 807 incident CVD events and 600 all‐cause mortality events.

·Patients with hypertriglyceridemia onset age <45 years were at greater risk than the matched controls, with hazard ratios of 2.61 for CVD, 4.69 for all‐cause mortality, 2.23 for all-cause mortality myocardial infarction, and 2.68 for stroke.

·There was a gradual decrease in risk estimates with each decade increase in the hypertriglyceridemia's onset age.

New-onset hypertriglyceridemia was shown to be associated with elevated risks for incident CVD and all-cause mortality regardless of traditional risk factors. Also, identifying hypertriglyceridemia at an earlier onset age was linked to greater CVD and all-cause mortality risk. The new‐onset hypertriglyceridemia–related CVD risk was driven mainly by increased stroke incidence among Chinese adults.

"Onset age of hypertriglyceridemia was a requisite determinant of CVD and all-cause mortality," the researchers wrote in their study. Although there is a strong association in younger onset, earlier identification and prevention targeting hypertriglyceridemia would positively influence CVD and all-cause mortality."

Reference:

Zhou H, Ding X, Yang Q, Chen S, Li Y, Zhou X, Wu S. Associations of Hypertriglyceridemia Onset Age With Cardiovascular Disease and All-Cause Mortality in Adults: A Cohort Study. J Am Heart Assoc. 2022 Oct 18;11(20):e026632. doi: 10.1161/JAHA.122.026632. Epub 2022 Oct 17. PMID: 36250656.