Association between Triglyceride Levels and Hypertension in Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: a Retrospective Cross-Sectional Study

Bo Yu^1,2,3*Sining Hu^1,2*Haibo Jia^1,2*Zhanqun Gao³Yubo Gao^1,2Chao Fang^1,2Dirui Zhang^1,2Wei Hao^1,2Chen Zhao^1,2

• ¹The Second Affiliated Hospital of Harbin Medical University, Harbin, China
• ²Harbin Medical University Key Laboratory of Myocardial Ischemia Ministry of Education, Harbin, China
• ³Hunan University of Medicine General Hospital, Huaihua, China

Background: This study aimed to investigate the association between serum triglyceride (TG) levels and the presence of hypertension in patients with coronary artery disease (CAD) and hypertension undergoing percutaneous coronary intervention (PCI). Methods: This retrospective study included 3,150 patients diagnosed with CAD who underwent PCI after coronary angiography (CAG) at the Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, between September 8, 2019, and February 27, 2022. Serum TG levels were measured within 24 h of admission, and covariates, including demographic data, clinical characteristics, and serum biomarkers, were collected. Multivariate logistic regression models were used to analyze the association between TG levels and hypertension. Results: A total of 36.8% (1,159/3,150) were ultimately included in the analysis, with 27.5% (319/1,159) presenting acute myocardial infarction (AMI). After adjusting for multiple confounding factors, TG levels were found to be independently associated with the presence of hypertension (odds ratio [OR]=1.23, 95% confidence interval [CI]: 1.03-1.47). When grouped by TG level quartiles, compared with the Q1 group, Q2, Q3, and Q4 showed significantly higher risks of CAD-related hypertension [OR, 95% CI: 1.98 (1.39–2.81), 1.80 (1.25–2.58), and 2.61 (1.68–4.05), respectively]. Furthermore, an additional analysis revealed a nonlinear relationship between TG and hypertension, characterized by a pronounced saturation effect which was particularly pronounced in patients with ejection fraction < 50%. Conclusion: This study is the first to demonstrate a J-shaped association between TG level and hypertension presence in patients with CAD after PCI, with an inflection point of 3.86 mmol/L. This association was more pronounced in patients with reduced EF, suggesting that in patients with cardiac dysfunction, there is a stronger association between TG levels and hypertension, which may warrant further investigation into the clinical benefits of TG management in this subgroup.