Pattern of Abnormal Serum Lipids and Lipoprotein Ratios in Nigerian Hypertensive Patients Seen in Clinical Practice

Abstract

Background: Hypertension is a major health problem worldwide. Its role, and other well-known coronary risk factors, especially dyslipidemia, in atherogenesis have informed estimation of cardiovascular risk. Hitherto, low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C) are prominent in guidelines but attempts are being made to include the use of lipoprotein ratios to optimize the predictive capacity of lipid profile in risk evaluation. This study aimed to describe pattern of lipids abnormalities, including the common lipid ratios used in clinical practice and to understand if they differ more with abdominal obesity which compared with peripheral obesity in subjects with systemic hypertension. Materials and Methods: Two hundred and eleven new adult hypertensive patients were studied in a hospital-based cross-sectional study. Serum lipids were measured and lipoprotein ratios calculated. SPSS IBM 20 was used to analyze data. Results: Mean age was 57.35±12.66 years. The prevalence of abnormal serum lipids in this study population was: elevated LDL-C (58.0%); elevated total cholesterol (38.9%); low HDL-C (31.4%); and elevated triglyceride (22.0%). For ratios of lipid profile, Castelli risk index-I (CRI-I) and Castelli risk index- II (CRI-II) were abnormal in 31.2% and 27.9%, respectively. Coronary disease risk ratio and atherogenic index of plasma were abnormal in 12.6% and 12.1%, respectively. Seven subjects (3.5%) had atherogenic lipid triad of low HDL-C, elevated LDL-C and high triglyceride with all the 7 subjects having abdominal obesity. Irrespective of the measure of obesity employed, LDL-C had the highest sensitivity. Conclusion: Lipids abnormalities were common in our hypertensive subjects, the commonest being high LDL-C. CRI-I and CRI-II demonstrated higher prevalence than the CDR and AIP as well as higher sensitivities, though their use may under-estimate the burden of dyslipidemia in our patients. Finally, irrespective of the measure of adiposity, lipids profiles in our study population were comparable.