NHHR was positively associated with prevalent hypertension in middle-aged and older Chinese adults, with a nonlinear relationship revealed by penalized spline analysis (P < .001).
NHHR was positively associated with prevalent hypertension in the study population.
A nonlinear association between NHHR and hypertension was identified by penalized spline analysis.
In the categorical model, the trend across NHHR categories in the fully adjusted model did not reach conventional statistical significance.
The association between NHHR and hypertension remained robust across subgroup and sensitivity analyses.
NHHR was calculated as the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol and was identified as a novel lipid marker.
This research looked at whether a lipid measurement called NHHR — calculated by dividing 'bad' cholesterol (non-HDL cholesterol) by 'good' cholesterol (HDL cholesterol) — is linked to high blood pressure (hypertension) in older Chinese adults. Using data from over 8,300 participants in a large national Chinese health study (average age 67), the researchers found that people with higher NHHR values were more likely to have hypertension, even after accounting for other health and lifestyle factors. An important finding was that the relationship between NHHR and hypertension was not a simple straight line — it was nonlinear, meaning the risk of hypertension changed at different rates depending on the NHHR level. This suggests the relationship between lipid balance and blood pressure may be more complex than previously appreciated. The findings held up when the researchers tested them in different subgroups and used different analytical approaches, strengthening confidence in the results. This research suggests that NHHR, a relatively simple and inexpensive blood test calculation, may be a useful indicator of hypertension risk in older populations. However, because this was a cross-sectional study (a snapshot in time), it cannot determine whether high NHHR causes hypertension or whether they simply tend to occur together. The authors call for future long-term studies to confirm these findings and better understand the direction of the relationship.
Huang L, Qin S, Qin F, Zhang Y. (2026). Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and hypertension in Chinese elderly: A cross-sectional study based on CHARLS.. Medicine. https://doi.org/10.1097/MD.0000000000050358