Association between Non HDL/HDL and Framingham Risk Score in Hypertension Population
Keywords:
hypertension, HDL cholesterol, non HDL cholesterol, Framingham Risk ScoreAbstract
Hypertension and dyslipidemia, encompassing both high-density lipoprotein (HDL) and non-HDL categories, are frequently linked with cardiovascular disease. An imbalance in HDL and non-HDL cholesterol levels, such as an increase in LDL, triglycerides, and total cholesterol, has been demonstrated to increase the risk of atherosclerosis, as reflected in the Framingham score. The present study employed a cross-sectional approach to examine the relationship or correlation between the variables. The sample consisted of hypertensive patients who met the inclusion criteria. The data presented herein were obtained through laboratory tests of HDL, LDL, triglyceride, and total cholesterol levels, as well as cardiovascular risk assessment using the Framingham score. The research data were analyzed using Kruskal-Wallis. A statistically significant relationship was identified between the HDL lipid profile, HDL cholesterol, LDL, triglycerides, and total cholesterol with the Framingham score (p < 0.05). The cardiovascular risk score (Framingham score) exhibited an increase concomitant with elevated non-HDL cholesterol levels and diminished HDL in hypertensive patients. The present study found a significant correlation between HDL and non-HDL levels or values and cardiovascular disease risk scores (FRS). These results underscore the significance of monitoring lipid profiles and nursing education in order to prevent cardiovascular complications through comprehensive risk management
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Adams, B., Jacocks, L., & Guo, H. (2020). Higher BMI is linked to an increased risk of heart attacks in European adults: A Mendelian randomisation study. BMC Cardiovascular Disorders, 20, 1–8. https://doi.org/10.1186/s12872-020-01535-6
Al Rahmad, A. H. (2021). Hubungan indeks massa tubuh dengan kolesterol, LDL, dan trigliserida pada pasien jantung koroner di Kota Banda Aceh. Jurnal Kesehatan, 9(1), 1–8.
Boren, J., Chapman, M. J., Krauss, R. M., Packard, C. J., Bentzon, J. F., Binder, C. J., Daemen, M. J., Demer, L. L., Hegele, R. A., & Nicholls, S. J. (2020). Low-density lipoproteins cause atherosclerotic cardiovascular disease: Pathophysiological, genetic, and therapeutic insights: A consensus statement from the European Atherosclerosis Society Consensus Panel. European Heart Journal, 41(24), 2313–2330. https://doi.org/10.1093/eurheartj/ehz962
Brunner, F. J., Waldeyer, C., Ojeda, F., Salomaa, V., Kee, F., Sans, S., Thorand, B., Giampaoli, S., Brambilla, P., & Tunstall-Pedoe, H. (2019). Application of non-HDL cholesterol for population-based cardiovascular risk stratification: Results from the Multinational Cardiovascular Risk Consortium. The Lancet, 394(10215), 2173–2183. https://doi.org/10.1016/S0140-6736(19)32519-X
Bueno, C. O. P., Beltrán España, J. A., Murgueitio Guzmán, C., Diaz-Brochero, C., & García Peña, Á. A. (2025). Cardiovascular risk and lipid control in older adults: Compliance with LDL and non-HDL cholesterol and triglyceride goals in a national cross-sectional study. Journal of Clinical Lipidology, 19(4), 869–877. https://doi.org/10.1016/j.jacl.2025.04.197
Burnier, M., & Egan, B. M. (2019). Adherence in hypertension: A review of prevalence, risk factors, impact, and management. Circulation Research, 124(7), 1124–1140. https://doi.org/10.1161/CIRCRESAHA.118.313220
Cao, Z., Zhuo, F., Yan, F., Huang, R., & Chen, Z. (2025). The non–high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) as predictors of hypertensive patients: Analyses of NHANES data with machine learning. Medicine, 104(46), eXXXXX. https://journals.lww.com/md-journal/fulltext/2025/11140/the_non_high_density_lipoprotein_cholesterol_to.13.aspx
Chen, S., & Cheng, W. (2022). Relationship between lipid profiles and hypertension: A cross-sectional study of 62,957 Chinese adult males. Frontiers in Public Health, 10, 895499. https://doi.org/10.3389/fpubh.2022.895499
Cleven, L., Krell-Roesch, J., Nigg, C. R., & Woll, A. (2020). The association between physical activity with incident obesity, coronary heart disease, diabetes and hypertension in adults: A systematic review of longitudinal studies published after 2012. BMC Public Health, 20, 1–15. https://doi.org/10.1186/s12889-020-09148-x
Dadkhah, S., & Sharain, K. (2022). Epidemiology and demographics of coronary artery disease. In Short stay management of chest pain (pp. 1–13). Springer. https://doi.org/10.1007/978-3-030-XXXX-X_1
Ference, B. A., Ginsberg, H. N., Graham, I., Ray, K. K., Packard, C. J., Bruckert, E., Hegele, R. A., Krauss, R. M., Raal, F. J., & Schunkert, H. (2017). Low-density lipoproteins cause atherosclerotic cardiovascular disease: 1. Evidence from genetic, epidemiologic, and clinical studies. European Heart Journal, 38(32), 2459–2472. https://doi.org/10.1093/eurheartj/ehx144
Fadlilah, S., Sucipto, A., Amestiasih, T., Widayati, R. W., Setiawan, D. I., & Aminah, S. (2020). Analysis of factors related to the risk of cardiovascular disease with Framingham Risk Score methods. International Medical Journal, 27(6), 1–6.
Jeong, S.-M., Choi, S., Kim, K., Kim, S.-M., Lee, G., Son, J. S., Yun, J.-M., & Park, S. M. (2018). Association of change in total cholesterol level with mortality: A population-based study. PLOS ONE, 13(4), e0196030. https://doi.org/10.1371/journal.pone.0196030
Liu, W., Laranjo, L., Klimis, H., Chiang, J., Yue, J., Marschner, S., Quiroz, J. C., Jorm, L., & Chow, C. K. (2023). Machine-learning versus traditional approaches for atherosclerotic cardiovascular risk prognostication in primary prevention cohorts: A systematic review and meta-analysis. European Heart Journal – Quality of Care and Clinical Outcomes, 9(4), 310–322. https://doi.org/10.1093/ehjqcco/qcad004
Ma, M., Hao, J., Liu, X., Lv, Y., Liu, F., & Wei, N. (2025). U-shaped relationship between the non-HDL to HDL cholesterol ratio and mortality in hypertensive individuals: A study from the NHANES database. Scientific Reports, 15(1), 20657. https://doi.org/10.1038/s41598-025-XXXXX
Maneesh, S., Atul, S., Chu, A., Austin, P. C., Anderson, T. J., Naimark, D. M. J., Farkouh, M. E., Lee, D. S., Roifman, I., Thanassoulis, G., Tu, K., Udell, J. A., & Wijeysundera, H. C. (2022). Population-based recalibration of the Framingham Risk Score and pooled cohort equations. Journal of the American College of Cardiology, 80(14), 1330–1342. https://doi.org/10.1016/j.jacc.2022.07.026
Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223–237. https://doi.org/10.1038/s41581-019-0244-2
Patel, N., Bhargava, A., Kalra, R., Parcha, V., Arora, G., Muntner, P., & Arora, P. (2019). Trends in lipid, lipoproteins, and statin use among US adults: Impact of 2013 cholesterol guidelines. Journal of the American College of Cardiology, 74(20), 2525–2528. https://doi.org/10.1016/j.jacc.2019.09.038
Raja, V., Aguiar, C., Alsayed, N., Chibber, Y. S., ElBadawi, H., Ezhov, M., Hermans, M. P., Pandey, R. C., Ray, K. K., Tokgözoglu, L., Zambon, A., Berrou, J.-P., & Farnier, M. (2023). Non-HDL-cholesterol in dyslipidemia: Review of the state-of-the-art literature and outlook. Atherosclerosis, 383, 117312. https://doi.org/10.1016/j.atherosclerosis.2023.117312
Rodondi, N., Locatelli, I., Aujesky, D., Butler, J., Vittinghoff, E., Simonsick, E., Satterfield, S., Newman, A. B., Wilson, P. W. F., & Pletcher, M. J. (2012). Framingham Risk Score and alternatives for prediction of coronary heart disease in older adults. PLOS ONE, 7(3), e34287. https://doi.org/10.1371/journal.pone.0034287
Soltani, S., Saraf-Bank, S., Basirat, R., Salehi-Abargouei, A., Mohammadifard, N., Sadeghi, M., Khosravi, A., Fadhil, I., Puska, P., & Sarrafzadegan, N. (2021). Community-based cardiovascular disease prevention programmes and cardiovascular risk factors: A systematic review and meta-analysis. Public Health, 200, 59–70. https://doi.org/10.1016/j.puhe.2021.08.016
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Beaton, A. Z., Boehme, A. K., & Buxton, A. E. (2023). Heart disease and stroke statistics—2023 update: A report from the American Heart Association. Circulation, 147(8), e93–e621. https://doi.org/10.1161/CIR.0000000000001123
World Health Organization. (2023). Global report on hypertension: The race against a silent killer. World Health Organization.
Xiang, A. S., & Kingwell, B. A. (2019). Rethinking good cholesterol: A clinician’s guide to understanding HDL. The Lancet Diabetes & Endocrinology, 7(7), 575–582. https://doi.org/10.1016/S2213-8587(19)30131-5
Zargar, A. A., Kumar, R., & Sharma, A. (2025). Prediction of different risk factors in relation to hyperlipidemia using Framingham Risk Score and cholesterol risk score in a tertiary care hospital. Current Diabetes Reviews, 21(2), e100724231817. https://doi.org/10.2174/157339981966623XXXX
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