A Comparison of Atherogenic Indices among Untreated Hypertensives in a Tertiary Hospital in Southern Nigeria
Year: 2017
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Cardiovascular disease (CVD) is the major cause of deaths worldwide because of increasing prevalence of hypertension, the major risk factor. Clustering of hypertension and dyslipidemia increases cardiovascular morbidity and mortality. Several atherogenic indices have been derived from standard lipid profiles measurement in an attempt to enhance predictive capacity of the lipid profile in CVD management. OBJECTIVES: To measure plasma lipids of untreated hypertensive patients and determine if the lipid ratios were superior in identifying dyslipidemia compared to the use of conventional lipid parameters. METHODS: Hypertensive subjects were consecutively enrolled from our cardiac clinic and had fasting lipid profile measured using standard procedures. The following atherogenic indices were then calculated from the lipid profile: Castelli Risk Index-I (total cholesterol/high-density lipoprotein), Castelli Risk Index-II (low-density lipoprotein/high-density lipoprotein), and the atherogenic index of plasma (AIP) [Log Triglyceride/HDL]. Descriptive statistics and correlation studies were used to determine the relationship between lipid parameters, atherogenic indices and gender. The area under the curve (AUC) of the receiver operator curve (ROC) and the 95% confidence intervals (CIs) were used to determine which index showed the highest accuracy in screening for dyslipidemia in the studied population. RESULTS: Two hundred and forty-eight subjects (108 males and 140 females) aged 20 to 86 years were recruited, mean age was 55.94 ±15.29 and 53.46±13.99 years for males and females respectively (p=0.186). Mean total cholesterol (TCH) and low-density lipoprotein (LDL-C) levels were significantly higher in the females (p=0.005 and p=0.021) respectively. Mean high-density lipoprotein (HDL-C) levels were higher in the females (p=0.003). 10.3% of patients had increased TCH 2.1% had elevated triglyceride, 37.3% had reduced HDL-C and 30.3% had elevated LDL-Cholesterol. AIP showed a strong inverse correlation with HDL-C (r= -0.447, p<0.001), LDL-C (r= -0.130, p=0.045), and TCH (r=-0.209, p=0.001). CRI-I showed an inverse correlation with HDL-C (r= -0.404, p<0.0001) and a positive correlation with TCH and LDL-C (r=0.146, p=0.02) and (r=0.128, p=0.04) respectively. CRI-II showed a strong inverse correlation with HDL-C (r=-0.406, p<0.0001) and a weak positive correlation with LDL (r=0.284, p<0.0001). Using the Receiver Operating Curve (ROC), the CRI-II most sensitive in identifying the hypertensive individuals with dyslipidemia (AUC= 0.882). CONCLUSIONS: Disorders of lipid is common amongst untreated hypertensive patients in Port Harcourt and CRI –II is most sensitive for identifying dyslipidemia in the population studied.
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2771301643