{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:32:50Z","timestamp":1780569170678,"version":"3.54.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"CAMS Innovation Fund for Medical Sciences","award":["2021-I2M-1-007"],"award-info":[{"award-number":["2021-I2M-1-007"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81825002"],"award-info":[{"award-number":["81825002"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Beijing Outstanding Young Scientist Program","award":["BJJWZYJH01201910023029"],"award-info":[{"award-number":["BJJWZYJH01201910023029"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Emerging evidence shows a close relationship between remnant cholesterol (RC) and hypertension. However, it is unknown whether RC is associated with the effects of intensive systolic blood pressure (SBP) lowering on cardiovascular outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We performed a post hoc analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. Participants were randomly allocated to intensive (110 to &amp;lt;130\u2005mmHg) or standard (130 to &amp;lt;150\u2005mmHg) treatment groups. The effects of intensive SBP lowering on the primary composite outcome (stroke, acute coronary syndrome, acute decompensated heart failure, coronary revascularization, atrial fibrillation, or cardiovascular death), the components thereof, and all-cause mortality were analysed by the tertile of baseline RC (lowest, middle, and highest). We followed 8206 patients for 3.33 years (median). The adjusted hazard ratios (HRs) [95% confidence interval (CI)] for the primary outcome were 1.06 (0.73\u20131.56), 0.58 (0.38\u20130.87), and 0.67 (0.46\u20130.96) in the lowest, middle, and highest RC tertiles, respectively (P for interaction = 0.11). However, significant heterogeneity in the treatment effects was observed when comparing the upper two tertiles with the lowest tertile (P for interaction = 0.033). For all-cause mortality, the adjusted HRs (95% CI) were 2.48 (1.30\u20134.73), 1.37 (0.71\u20132.65), and 0.42 (0.22\u20130.80) in the lowest, middle, and highest RC tertiles, respectively (P for interaction &amp;lt;0.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Baseline RC concentrations were associated with the effects of intensive SBP lowering on the primary composite cardiovascular outcome and all-cause mortality in hypertensive patients. These results are hypothesis-generating and merit further study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Registration<\/jats:title>\n                  <jats:p>STEP ClinicalTrials.gov number: NCT03015311<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwae001","type":"journal-article","created":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T22:11:53Z","timestamp":1704233513000},"page":"997-1004","source":"Crossref","is-referenced-by-count":12,"title":["Remnant cholesterol and intensive blood pressure control in older patients with hypertension: a <i>post hoc<\/i> analysis of the STEP randomized trial"],"prefix":"10.1093","volume":"31","author":[{"given":"Ruixue","family":"Yang","sequence":"first","affiliation":[{"name":"Hypertension Center, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Fuwai Hospital , Beilishi Road 167, Xicheng District, Beijing 100037 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Hospital of Shanxi Medical University , No. 85 Jiefang South Road, Yingze District, Taiyuan, Shanxi Province 030001 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxu","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Benxi Railway Hospital , No. 25 Yingchun Street, Pingshan District, Benxi, Liaoning Province 117000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohong","family":"Yang","sequence":"additional","affiliation":[{"name":"Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau , Characteristic Medical Center of the Chinese People's Armed Police Forces, No. 220 Chenglin Road, Tianjin 300162 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8928-9570","authenticated-orcid":false,"given":"Jun","family":"Cai","sequence":"additional","affiliation":[{"name":"Hypertension Center, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Fuwai Hospital , Beilishi Road 167, Xicheng District, Beijing 100037 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,3]]},"reference":[{"key":"2024060223504837100_zwae001-B1","doi-asserted-by":"crossref","first-page":"e012615","DOI":"10.1161\/CIRCIMAGING.121.012615","article-title":"Remnant cholesterol: the leftovers and their contribution to atherosclerotic cardiovascular disease","volume":"14","author":"Bruemmer","year":"2021","journal-title":"Circ Cardiovasc Imaging"},{"key":"2024060223504837100_zwae001-B2","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1177\/2047487319899622","article-title":"Beyond LDL-C levels, does remnant cholesterol estimation matter?","volume":"27","author":"Pirillo","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2024060223504837100_zwae001-B3","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1210\/er.2018-00184","article-title":"The forgotten lipids: triglycerides, remnant cholesterol, and atherosclerotic cardiovascular disease risk","volume":"40","author":"Sandesara","year":"2019","journal-title":"Endocr Rev"},{"key":"2024060223504837100_zwae001-B4","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1093\/eurheartj\/ehs431","article-title":"Genetically elevated non-fasting triglycerides and calculated remnant cholesterol as causal risk factors for myocardial infarction","volume":"34","author":"J\u00f8rgensen","year":"2013","journal-title":"Eur Heart J"},{"key":"2024060223504837100_zwae001-B5","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1373\/clinchem.2015.253757","article-title":"Increased remnant cholesterol explains part of residual risk of all-cause mortality in 5414 patients with ischemic heart disease","volume":"62","author":"Jepsen","year":"2016","journal-title":"Clin Chem"},{"key":"2024060223504837100_zwae001-B6","doi-asserted-by":"crossref","first-page":"2288","DOI":"10.1093\/eurheartj\/ehaa172","article-title":"Triglycerides and remnant cholesterol associated with risk of aortic valve stenosis: Mendelian randomization in the Copenhagen General Population Study","volume":"41","author":"Kaltoft","year":"2020","journal-title":"Eur Heart J"},{"key":"2024060223504837100_zwae001-B7","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.jacc.2012.08.1026","article-title":"Remnant cholesterol as a causal risk factor for ischemic heart disease","volume":"61","author":"Varbo","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2024060223504837100_zwae001-B8","doi-asserted-by":"crossref","first-page":"e024366","DOI":"10.1161\/JAHA.121.024366","article-title":"Remnant cholesterol predicts risk of cardiovascular events in patients with myocardial infarction with nonobstructive coronary arteries","volume":"11","author":"Gao","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2024060223504837100_zwae001-B9","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1161\/CIRCULATIONAHA.117.032318","article-title":"Triglyceride-rich lipoprotein cholesterol and risk of cardiovascular events among patients receiving statin therapy in the TNT trial","volume":"138","author":"Vallejo-Vaz","year":"2018","journal-title":"Circulation"},{"key":"2024060223504837100_zwae001-B10","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1161\/STROKEAHA.121.037756","article-title":"Remnant cholesterol variability and incident ischemic stroke in the general population","volume":"53","author":"Li","year":"2022","journal-title":"Stroke"},{"key":"2024060223504837100_zwae001-B11","doi-asserted-by":"crossref","first-page":"4324","DOI":"10.1093\/eurheartj\/ehab432","article-title":"Remnant cholesterol predicts cardiovascular disease beyond LDL and ApoB: a primary prevention study","volume":"42","author":"Quispe","year":"2021","journal-title":"Eur Heart J"},{"key":"2024060223504837100_zwae001-B12","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/jch.14384","article-title":"Association between remnant cholesterol and arterial stiffness: a secondary analysis based on a cross-sectional study","volume":"24","author":"Wang","year":"2022","journal-title":"J Clin Hypertens"},{"key":"2024060223504837100_zwae001-B13","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s12944-021-01490-0","article-title":"Associations between remnant lipoprotein cholesterol and central systolic blood pressure in a Chinese community-based population: a cross-sectional study","volume":"20","author":"Li","year":"2021","journal-title":"Lipids Health Dis"},{"key":"2024060223504837100_zwae001-B14","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1093\/ajh\/hpt011","article-title":"High level of plasma remnant-like particle cholesterol may predispose to development of hypertension in normotensive subjects","volume":"26","author":"Kasahara","year":"2013","journal-title":"Am J Hypertens"},{"key":"2024060223504837100_zwae001-B15","doi-asserted-by":"crossref","first-page":"830347","DOI":"10.3389\/fendo.2022.830347","article-title":"High remnant cholesterol level potentiates the development of hypertension","volume":"13","author":"Chen","year":"2022","journal-title":"Front Endocrinol"},{"key":"2024060223504837100_zwae001-B16","doi-asserted-by":"crossref","first-page":"951635","DOI":"10.3389\/fendo.2022.951635","article-title":"The association of remnant cholesterol (RC) and interaction between RC and diabetes on the subsequent risk of hypertension","volume":"13","author":"Wang","year":"2022","journal-title":"Front Endocrinol"},{"key":"2024060223504837100_zwae001-B17","doi-asserted-by":"crossref","first-page":"685385","DOI":"10.3389\/fcvm.2021.685385","article-title":"Change in postprandial level of remnant cholesterol after a daily breakfast in Chinese patients with hypertension","volume":"8","author":"Xu","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"2024060223504837100_zwae001-B18","doi-asserted-by":"crossref","first-page":"2292","DOI":"10.1097\/HJH.0000000000003259","article-title":"Hypertension, remnant cholesterol and cardiovascular disease: evidence from the China health and retirement longitudinal study","volume":"40","author":"Zheng","year":"2022","journal-title":"J Hypertens"},{"key":"2024060223504837100_zwae001-B19","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1056\/NEJMoa2111437","article-title":"Trial of intensive blood-pressure control in older patients with hypertension","volume":"385","author":"Zhang","year":"2021","journal-title":"N Engl J Med"},{"key":"2024060223504837100_zwae001-B20","doi-asserted-by":"crossref","first-page":"105913","DOI":"10.1016\/j.cct.2019.105913","article-title":"Strategy of blood pressure intervention in the elderly hypertensive patients (STEP): rational, design, and baseline characteristics for the main trial","volume":"89","author":"Zhang","year":"2020","journal-title":"Contemp Clin Trials"},{"key":"2024060223504837100_zwae001-B21","doi-asserted-by":"crossref","first-page":"2937","DOI":"10.1681\/ASN.2006040368","article-title":"Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease","volume":"17","author":"Ma","year":"2006","journal-title":"J Am Soc Nephrol"},{"key":"2024060223504837100_zwae001-B22","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1161\/CIRCULATIONAHA.107.699579","article-title":"General cardiovascular risk profile for use in primary care","volume":"117","author":"D\u2019Agostino","year":"2008","journal-title":"Circulation"},{"key":"2024060223504837100_zwae001-B23","doi-asserted-by":"crossref","first-page":"2712","DOI":"10.1016\/j.jacc.2020.10.008","article-title":"Remnant cholesterol, not LDL cholesterol, is associated with incident cardiovascular disease","volume":"76","author":"Casta\u00f1er","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2024060223504837100_zwae001-B24","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1177\/2047487319887578","article-title":"Remnant cholesterol, coronary atheroma progression and clinical events in statin-treated patients with coronary artery disease","volume":"27","author":"Elshazly","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2024060223504837100_zwae001-B25","doi-asserted-by":"crossref","first-page":"993097","DOI":"10.3389\/fcvm.2022.993097","article-title":"Association between remnant cholesterol and arterial stiffness in a Chinese community-based population: a cross-sectional study","volume":"9","author":"Liu","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"2024060223504837100_zwae001-B26","doi-asserted-by":"crossref","first-page":"2854","DOI":"10.1093\/eurheartj\/ehq340","article-title":"Assessment of atherosclerosis: the role of flow-mediated dilatation","volume":"31","author":"Charakida","year":"2010","journal-title":"Eur Heart J"},{"key":"2024060223504837100_zwae001-B27","doi-asserted-by":"crossref","first-page":"406960","DOI":"10.1155\/2014\/406960","article-title":"Roles of inflammation, oxidative stress, and vascular dysfunction in hypertension","volume":"2014","author":"Dinh","year":"2014","journal-title":"BioMed Res Int"},{"key":"2024060223504837100_zwae001-B28","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0021-9150(02)00057-6","article-title":"Relationship between insulin-resistance and remnant-like particle cholesterol","volume":"164","author":"Ohnishi","year":"2002","journal-title":"Atherosclerosis"},{"key":"2024060223504837100_zwae001-B29","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1002\/clc.4960251110","article-title":"Possible relationship between insulin resistance and remnant-like lipoprotein particles in coronary endothelial dysfunction","volume":"25","author":"Inoue","year":"2002","journal-title":"Clin Cardiol"},{"key":"2024060223504837100_zwae001-B30","doi-asserted-by":"crossref","first-page":"4300","DOI":"10.3390\/ijms23084300","article-title":"Emerging evidence of pathological roles of very-low-density lipoprotein (VLDL)","volume":"23","author":"Huang","year":"2022","journal-title":"Int J Mol Sci"},{"key":"2024060223504837100_zwae001-B31","doi-asserted-by":"crossref","first-page":"R115","DOI":"10.1530\/JOE-16-0237","article-title":"Very low-density lipoprotein (VLDL)-induced signals mediating aldosterone production","volume":"232","author":"Tsai","year":"2017","journal-title":"J Endocrinol"},{"key":"2024060223504837100_zwae001-B32","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1056\/NEJMoa1511939","article-title":"A randomized trial of intensive versus standard blood-pressure control","volume":"373","author":"The SPRINT Research Group","year":"2015","journal-title":"N Engl J Med"},{"key":"2024060223504837100_zwae001-B33","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1016\/j.jacc.2018.01.074","article-title":"Impact of cardiovascular risk on the relative benefit and harm of intensive treatment of hypertension","volume":"71","author":"Phillips","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2024060223504837100_zwae001-B34","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1016\/j.jacc.2021.02.058","article-title":"Patient selection for intensive blood pressure management based on benefit and adverse events","volume":"77","author":"Bress","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2024060223504837100_zwae001-B35","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1177\/2047487318800741","article-title":"Effect of intensive blood pressure lowering on cardiovascular outcomes based on cardiovascular risk: a secondary analysis of the SPRINT trial","volume":"26","author":"Attar","year":"2019","journal-title":"Eur J Prev Cardiol"},{"key":"2024060223504837100_zwae001-B36","doi-asserted-by":"crossref","first-page":"707701","DOI":"10.3389\/fcvm.2021.707701","article-title":"The U-shaped association of non-high-density lipoprotein cholesterol levels with all-cause and cardiovascular mortality among patients with hypertension","volume":"8","author":"Cheng","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"2024060223504837100_zwae001-B37","doi-asserted-by":"crossref","first-page":"m4266","DOI":"10.1136\/bmj.m4266","article-title":"Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study","volume":"371","author":"Johannesen","year":"2020","journal-title":"BMJ"},{"key":"2024060223504837100_zwae001-B38","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/nrcardio.2018.3","article-title":"Advances in lipid-lowering therapy through gene-silencing technologies","volume":"15","author":"Nordestgaard","year":"2018","journal-title":"Nat Rev Cardiol"},{"key":"2024060223504837100_zwae001-B39","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1056\/NEJMoa2210645","article-title":"Triglyceride lowering with pemafibrate to reduce cardiovascular risk","volume":"387","author":"Das Pradhan","year":"2022","journal-title":"N Engl J Med"},{"key":"2024060223504837100_zwae001-B40","doi-asserted-by":"crossref","first-page":"4833","DOI":"10.1093\/eurheartj\/ehab293","article-title":"Directly measured vs. calculated remnant cholesterol identifies additional overlooked individuals in the general population at higher risk of myocardial infarction","volume":"42","author":"Varbo","year":"2021","journal-title":"Eur Heart J"},{"key":"2024060223504837100_zwae001-B41","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1093\/eurheartj\/ehac822","article-title":"Elevated remnant cholesterol, plasma triglycerides, and cardiovascular and non-cardiovascular mortality","volume":"44","author":"Wadstr\u00f6m","year":"2023","journal-title":"Eur Heart J"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwae001\/56254443\/zwae001.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/31\/8\/997\/58009468\/zwae001.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/31\/8\/997\/58009468\/zwae001.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,2]],"date-time":"2024-06-02T23:51:31Z","timestamp":1717372291000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/31\/8\/997\/7505246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,3]]},"references-count":41,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,1,3]]},"published-print":{"date-parts":[[2024,6,3]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwae001","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,6]]},"published":{"date-parts":[[2024,1,3]]}}}