{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:06:33Z","timestamp":1781712393552,"version":"3.54.5"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Despite available studies, the link between dyslipidemia and hypertension remains unclear, particularly among different ethnicities, age groups, and genders. This study aimed to assess this association in the Iranian elderly population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a cross-sectional study, we used data from phase II of the Bushehr Elderly Health Program (BEHP). Participants were divided into hypertensive and non-hypertensive groups based on their blood pressure. The association between lipid parameters and hypertension (HTN) was evaluated using multiple logistic regression analysis. Additionally, we conducted a subgroup analysis by gender, age, and BMI (Body Mass Index).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, 1,918 people with a mean age of 62.10\u2009\u00b1\u20098.05 were included. Of them, 1,133 (59.1%) were hypertensive, and 57.2% were females (1,097). Among the lipid profiles, individuals with HTN had higher levels of triglyceride (TG) and remnant cholesterol (RC). There was a negative association between high-density lipoprotein (HDL-c) levels and high blood pressure 0.987(0.978\u20130.995), p:0.003, and a positive association between TG and RC\u2009\u2265\u200930 levels and HTN ([1.003(1.002\u20131.005), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001]; [1.36 (1.123\u20131.648), p:0.002], respectively). This positive association was observed after full adjustment for age, gender, and BMI. While HDL-C was lower and RC levels were significantly higher only in the hypertensive people aged \u226465 (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01), higher RC levels were observed in the hypertensive groups independent of BMI levels (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). Moreover, the levels of RC\u2009\u2265\u200930\u2005mg\/dl were associated with the risk of HTN only in males.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the middle-aged and elderly hypertension population, there is a positive and statistically significant association between RC and HTN. This suggests that this indicator is associated with HTN, particularly in those with normal or subnormal levels of traditional risk factors. Moreover, this association may be affected by age and anthropometric parameters as well as life style factors.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1483778","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T14:54:31Z","timestamp":1759503271000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Remnant cholesterol, not LDL cholesterol, is associated with the risk of hypertension in the middle-aged and elderly population: Bushehr Elderly Health cohort"],"prefix":"10.3389","volume":"12","author":[{"given":"Behnaz","family":"Esmaeili","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahnaz","family":"Esmaeili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noushin","family":"Fahimfar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Rezaei Tavirani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farideh","family":"Razi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iraj","family":"Nabipour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Khashayar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Bandarian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/S0140-6736(05)17741-1","article-title":"Global burden of hypertension: analysis of worldwide data","volume":"365","author":"Kearney","year":"2005","journal-title":"Lancet"},{"key":"B2","first-page":"1","article-title":"Hypertension prevalence and control among adults: United States, 2015\u22122016","author":"Fryar","year":"2017","journal-title":"NCHS Data Brief"},{"key":"B3","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1038\/s41569-021-00559-8","article-title":"Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension","volume":"18","author":"Zhou","year":"2021","journal-title":"Nat Rev Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e042821","DOI":"10.1136\/bmjopen-2020-042821","article-title":"Association between dyslipidemia and risk of type 2 diabetes mellitus in middle-aged and older Chinese adults: a secondary analysis of a nationwide cohort","volume":"11","author":"Peng","year":"2021","journal-title":"BMJ Open"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1016\/S0140-6736(02)11403-6","article-title":"Selected major risk factors and global and regional burden of disease","volume":"360","author":"Ezzati","year":"2002","journal-title":"Lancet"},{"key":"B6","first-page":"456","article-title":"Awareness, treatment and control of pre-hypertension and hypertension among adults in Iran","volume":"19","author":"Esteghamati","year":"2016","journal-title":"Arch Iran Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e0187240","DOI":"10.1371\/journal.pone.0187240","article-title":"Recent development of risk-prediction models for incident hypertension: an updated systematic review","volume":"12","author":"Sun","year":"2017","journal-title":"PLoS One"},{"key":"B8","doi-asserted-by":"publisher","first-page":"177","DOI":"10.3109\/08037051.2015.1116221","article-title":"Incidence and risk factors of isolated systolic and diastolic hypertension: a 10 year follow-up of the Tehran lipids and glucose study","volume":"25","author":"Asgari","year":"2016","journal-title":"Blood Press"},{"key":"B9","doi-asserted-by":"publisher","first-page":"895499","DOI":"10.3389\/fpubh.2022.895499","article-title":"Relationship between lipid profiles and hypertension: a cross-sectional study of 62,957 Chinese adult males","volume":"10","author":"Chen","year":"2022","journal-title":"Front Public Health"},{"key":"B10","doi-asserted-by":"publisher","first-page":"76","DOI":"10.5937\/arhfarm74-47908","article-title":"The role of serum lipid profile in the pathogenesis of arterial hypertension","volume":"74","author":"Rafaqat","year":"2024","journal-title":"Arh Farm"},{"key":"B11","doi-asserted-by":"publisher","first-page":"904237","DOI":"10.3389\/fendo.2022.904237","article-title":"Association of lipid levels with the prevalence of hypertension in Chinese women: a cross-sectional study based on 32 health check centers","volume":"13","author":"Deng","year":"2022","journal-title":"Front Endocrinol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/s12944-023-01853-9","article-title":"Association between atherogenic index of plasma and prehypertension or hypertension among normoglycemia subjects in a Japan population: a cross-sectional study","volume":"22","author":"Tan","year":"2023","journal-title":"Lipids Health Dis"},{"key":"B13","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s40256-015-0128-1","article-title":"Hypercholesterolemia and hypertension: two sides of the same coin","volume":"15","author":"Ivanovic","year":"2015","journal-title":"Am J Cardiovasc Drugs"},{"key":"B14","doi-asserted-by":"publisher","first-page":"E47","DOI":"10.25011\/cim.v42i3.33092","article-title":"Relationship between blood lipid and arterial stiffness in hypertension","volume":"42","author":"Si","year":"2019","journal-title":"Clin Invest Med"},{"key":"B15","doi-asserted-by":"publisher","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":"B16","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1097\/HJH.0000000000003051","article-title":"Comprehensive biomarker profiling of hypertension in 36985 Finnish individuals","volume":"40","author":"Palmu","year":"2022","journal-title":"J Hypertens"},{"key":"B17","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1111\/joim.13059","article-title":"Contribution of remnant cholesterol to cardiovascular risk","volume":"288","author":"Langsted","year":"2020","journal-title":"J Intern Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1063562","DOI":"10.3389\/fcvm.2023.1063562","article-title":"Predictive value of remnant cholesterol level for all-cause mortality in heart failure patients","volume":"10","author":"Zhao","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1097\/MOL.0000000000000429","article-title":"Remnant lipoproteins","volume":"28","author":"Varbo","year":"2017","journal-title":"Curr Opin Lipidol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1260764","DOI":"10.3389\/fendo.2023.1260764","article-title":"Remnant cholesterol associates with hypertension beyond low-density lipoprotein cholesterol among the general US adult population","volume":"14","author":"Shi","year":"2023","journal-title":"Front Endocrinol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1038\/s41440-024-01609-7","article-title":"Is remnant cholesterol a new therapeutic target for preventing hypertension?","volume":"47","author":"Kunimura","year":"2024","journal-title":"Hypertens Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1161\/ATVBAHA.116.308834","article-title":"Remnant cholesterol elicits arterial wall inflammation and a multilevel cellular immune response in humans","volume":"37","author":"Bernelot Moens","year":"2017","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1161\/CIRCULATIONAHA.113.003008","article-title":"Elevated remnant cholesterol causes both low-grade inflammation and ischemic heart disease, whereas elevated low-density lipoprotein cholesterol causes ischemic heart disease without inflammation","volume":"128","author":"Varbo","year":"2013","journal-title":"Circulation"},{"key":"B24","doi-asserted-by":"publisher","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":"B25","doi-asserted-by":"publisher","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":"B26","doi-asserted-by":"publisher","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":"B27","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12944-023-01915-y","article-title":"Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators","volume":"22","author":"Wu","year":"2023","journal-title":"Lipids Health Dis"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e035363","DOI":"10.1136\/bmjopen-2019-035363","article-title":"Protocol for a multicentre, prospective cohort study of clinical, proteomic and genomic patterns associated with osteoporosis to develop a multidimensional fracture assessment tool: the PoCOsteo study","volume":"10","author":"Khashayar","year":"2020","journal-title":"BMJ Open"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e009597","DOI":"10.1136\/bmjopen-2015-009597","article-title":"Bushehr Elderly Health (BEH) programme, phase I (cardiovascular system)","volume":"5","author":"Ostovar","year":"2015","journal-title":"BMJ Open"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e013606","DOI":"10.1136\/bmjopen-2016-013606","article-title":"Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II)","volume":"7","author":"Shafiee","year":"2017","journal-title":"BMJ Open"},{"key":"B31","year":""},{"key":"B32","doi-asserted-by":"publisher","first-page":"e13498","DOI":"10.1111\/1753-0407.13498","article-title":"Association of remnant cholesterol and newly diagnosed early-onset type 2 diabetes mellitus in Chinese population: a retrospective cross-sectional study","volume":"16","author":"Dong","year":"2024","journal-title":"J Diabetes"},{"key":"B33","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk","volume":"41","author":"Mach","year":"2020","journal-title":"Eur Heart J"},{"key":"B34","doi-asserted-by":"publisher","first-page":"29","DOI":"10.5334\/gh.780","article-title":"Sex-specific incidence rates and risk factors for hypertension during 13 years of follow-up: the Tehran lipid and glucose study","volume":"15","author":"Asgari","year":"2020","journal-title":"Glob Heart"},{"key":"B35","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1038\/jhh.2011.70","article-title":"Triglycerides and triglycerides to high-density lipoprotein cholesterol ratio are strong predictors of incident hypertension in middle eastern women","volume":"26","author":"Tohidi","year":"2012","journal-title":"J Hum Hypertens"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2561","DOI":"10.1093\/eurheartj\/ehn061","article-title":"Dyslipidaemia as a predictor of hypertension in middle-aged men","volume":"29","author":"Laaksonen","year":"2008","journal-title":"Eur Heart J"},{"key":"B37","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s12944-020-01331-6","article-title":"Lower or higher HDL-C levels are associated with cardiovascular events in the general population in rural China","volume":"19","author":"Yu","year":"2020","journal-title":"Lipids Health Dis"},{"key":"B38","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1038\/s41371-021-00548-x","article-title":"Adjustment for body mass index changes inverse associations of HDL-cholesterol with blood pressure and hypertension to positive associations","volume":"36","author":"Yang","year":"2022","journal-title":"J Hum Hypertens"},{"key":"B39","doi-asserted-by":"publisher","first-page":"e034226","DOI":"10.1136\/bmjopen-2019-034226","article-title":"Age-related trends in lipid levels: a large-scale cross-sectional study of the general Chinese population","volume":"10","author":"Feng","year":"2020","journal-title":"BMJ Open"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1888","DOI":"10.1161\/CIRCULATIONAHA.105.563213","article-title":"Reciprocal relationships between insulin resistance and endothelial dysfunction: molecular and pathophysiological mechanisms","volume":"113","author":"Kim","year":"2006","journal-title":"Circulation"},{"key":"B41","doi-asserted-by":"publisher","first-page":"761","DOI":"10.7326\/0003-4819-139-9-200311040-00011","article-title":"Pathogenesis of hypertension","volume":"139","author":"Oparil","year":"2003","journal-title":"Ann Intern Med"},{"key":"B42","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1007\/s11695-010-0170-7","article-title":"Association of body mass index and lipid profiles: evaluation of a broad spectrum of body mass index patients including the morbidly obese","volume":"21","author":"Shamai","year":"2011","journal-title":"Obes Surg"},{"key":"B43","doi-asserted-by":"publisher","first-page":"3031","DOI":"10.1016\/j.jacc.2021.04.059","article-title":"Triglycerides and residual atherosclerotic risk","volume":"77","author":"Raposeiras-Roubin","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"B44","doi-asserted-by":"publisher","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":"B45","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1016\/j.jacl.2017.06.015","article-title":"Residual atherosclerotic cardiovascular disease risk in statin-treated adults: the multi-ethnic study of atherosclerosis","volume":"11","author":"Wong","year":"2017","journal-title":"J Clin Lipidol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1038\/s41440-023-01558-7","article-title":"Remnant cholesterol and risk of incident hypertension: a population-based prospective cohort study","volume":"47","author":"Guo","year":"2024","journal-title":"Hypertens Res"},{"key":"B47","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1097\/MOL.0000000000000682","article-title":"Remnant lipoproteins: are they equal to or more atherogenic than LDL?","volume":"31","author":"Salinas","year":"2020","journal-title":"Curr Opin Lipidol"},{"key":"B48","doi-asserted-by":"publisher","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":"B49","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1194\/jlr.M055780","article-title":"Influence of physiological changes in endogenous estrogen on circulating PCSK9 and LDL cholesterol","volume":"56","author":"Ghosh","year":"2015","journal-title":"J Lipid Res"},{"key":"B50","doi-asserted-by":"publisher","first-page":"4208","DOI":"10.1111\/bph.14624","article-title":"Sex differences in mechanisms of arterial stiffness","volume":"176","author":"DuPont","year":"2019","journal-title":"Br J Pharmacol"},{"key":"B51","doi-asserted-by":"publisher","first-page":"304","DOI":"10.26719\/emhj.19.042","article-title":"Hypertension and associated factors in the Ilamic Republic of Iran: a population-based study","volume":"26","author":"Katibeh","year":"2020","journal-title":"East Mediterr Health J"},{"key":"B52","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1038\/nrneph.2017.189","article-title":"Sex-specific differences in hypertension and associated cardiovascular disease","volume":"14","author":"Colafella","year":"2018","journal-title":"Nat Rev Nephrol"},{"key":"B53","doi-asserted-by":"publisher","first-page":"31","DOI":"10.4103\/jrms.JRMS_472_18","article-title":"Prevalence and predictors of prediabetes and its coexistence with high blood pressure in first-degree relatives of patients with type 2 diabetes: a 9-year cohort study","volume":"25","author":"Hadi Alijanvand","year":"2020","journal-title":"J Res Med Sci"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1483778\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T14:54:32Z","timestamp":1759503272000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1483778\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":53,"alternative-id":["10.3389\/fcvm.2025.1483778"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1483778","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,3]]},"article-number":"1483778"}}