Background/Purpose: In inflammatory disorders, highest incidence of cardiovascular (CV) events paradoxically occurs at lower lipid levels [ARD.70:482], especially for high-density lipoprotein cholesterol (HDLc). Current data in general, non-inflammatory population suggest a similar but milder phenomenon [Circulation.107:391]. Serum uric acid (SUA) levels appear to determine the inflammatory status of the subjects, even in normouricemia [EHJ.27:1174]. The aim of this work was to assess whether inflammatory status and SUA associate with HDLc levels in a hypertensive population aged 65 years or older.

Methods: Analysis of the FAPRES study (cross-sectional study aimed that assessed the prevalence of atrial fibrillation in hypertensive patients aged 65 years or older). Inflammatory status was considered based on serum leukocytes. A comparison between serum lipids levels (HDLc, low-density lipoprotein-cholesterol [LDLc], total cholesterol [TCh], triglycerides [TG]) and different tertiles of leukocytes and SUA was performed using ANOVA. Correlation between leukocytes and SUA was analyzed by Pearson’s coefficient. In case of significant differences, a multivariate linear regression model was built for each lipid parameter to adjust for potential confounders (age, gender, CV risk factors, renal failure, BMI, use of diuretics or statins, prior coronary disease, sinus rhythm at EKG).

Results: 860 patients were analyzed, mean aged 72.9 years (SD±5.8), 52.5% females. Leukocytes and SUA levels mildly correlated (r=0.127, p=0.001). Lower HDLc and higher TG levels were found in upper tertiles of both leukocytes and SUA, with no differences on TCh and LDLc (Table). Multivariate analysis confirmed an independent, inverse association of HDLc with both leukocytes (β=-0.001, p=0.025) and SUA (β=-1.054, p=0.037); and for TG levels, an independent, direct association was found with both leukocytes (β=+0.004, p=0.049) and SUA levels (β=+8.411, p=0.003).

Conclusion: In a hypertensive population aged 65 years or older, both inflammatory status and SUA levels showed an inverse, independent association with HDLc, following current data on patients with inflammatory disorders. Interestingly, SUA and leukocytes mildly correlated. This phenomenon might help to define a pro-atherogenic profile on the general population.