Associations of Hypertriglyceridemia Onset Age With Cardiovascular Disease and All-Cause Mortality in Adults: A Cohort Study

Abstract

Background Limited studies have involved new-onset hypertriglyceridemia, and this study was to evaluate the associations of hypertriglyceridemia onset age with cardiovascular diseases (CVD) and all-cause mortality. Methods and Results This population-based prospective study enrolled 98 779 participants free of hypertriglyceridemia and CVD at baseline in the Kailuan study initiated in June 2006. All participants underwent health checkups biennially until December 2017, and a total of 13 832 participants developed new hypertriglyceridemia. A 1:1 age- (±1 year) and sex-matched analysis was applied to select control subject of the same year for each new-onset case. There were 13 056 case-control pairs included. The total follow-up time was 179 409 person-years, with a median follow-up time of 7.0 years. Primary outcomes were CVD and all-cause mortality, and hazard ratios were estimated after adjustment for baseline characteristics. A total of 807 incident CVD events and 600 all-cause mortality events were documented. After multivariable adjustment, participants with hypertriglyceridemia onset age <45 years had the highest risk compared with matched controls, with hazard ratios of 2.61 (95% CI, 1.59-4.27) for CVD, 4.69 (95% CI, 2.34-9.40) for all-cause mortality, 2.23 (95% CI, 0.67-7.38) for myocardial infarction, and 2.68 (95% CI, 1.56-4.62) for stroke. The risk estimates gradually decreased with each decade increase in the onset age of hypertriglyceridemia. Conclusions Among Chinese adults, hypertriglyceridemia identified at an earlier onset age was associated with higher risks for CVD and all-cause mortality.

Keywords: cardiovascular disease risk; cohort study; hypertriglyceridemia onset age; mortality risk.

Figure 1. Hazard ratios for incident cardiovascular disease and all‐cause mortality among participants with new‐onset hypertriglyceridemia versus control subjects across age groups.

All models were adjusted for education background, smoking status, drinking status, physical exercise, diabetes, hypertension, hypoglycemic medications, antihypertensive medications, body mass index, high‐density lipoprotein cholesterol, and low‐density lipoprotein cholesterol. P for interaction was between age groups and new‐onset hypertriglyceridemia groups.

Figure 2. Hazard ratios for subtypes of cardiovascular disease among participants with new‐onset hypertriglyceridemia versus control subjects across age groups.

All models were adjusted for education background, smoking status, drinking status, physical exercise, diabetes, hypertension, hypoglycemic medications, antihypertensive medications, body mass index, high‐density lipoprotein cholesterol, and low‐density lipoprotein cholesterol. P for interaction was between age groups and new‐onset hypertriglyceridemia groups.

Figure 3. Hazard ratios for subtypes of stroke among participants with new‐onset hypertriglyceridemia versus control subjects across age groups.

All models were adjusted for education background, smoking status, drinking status, physical exercise, diabetes, hypertension, hypoglycemic medications, antihypertensive medications, body mass index, high‐density lipoprotein cholesterol, and low‐density lipoprotein cholesterol. P for interaction was between age groups and new‐onset hypertriglyceridemia groups.