To ascertain if the lipid ratios can predict the occurrence of obstructive peripheral artery disease (PAD) in hypertensive patients.Design and Method:
A total of 920 hypertensive patients (51.3% female, age 64.22 ± 12.01 years) were consecutively included in this cross-sectional study. None of the patients were taking drugs or were in situations known to affect lipoprotein metabolism. Total cholesterol, triglycerides and HDL cholesterol were measured. LDL cholesterol was obtained by Friedewald's formula (if triglycerides <3.39 mmol/l) or by ultracentrifugation. The LDL-Cholesterol/HDL-Cholesterol, Total Cholesterol/HDL-Cholesterol and Triglycerides/HDL-Cholesterol ratios were calculated in all patients. Blood pressure and heart rate were measured in standard conditions. Ankle-Brachial index (ABI) was estimated bilaterally as the ratio of ankle (left and right) systolic blood pressure and brachial (highest upper limb) systolic blood pressure. The normal range for ABI was 0.9–1.3, and individuals with ABI<0.9 were classified as having peripheral arterial disease.Results:
Significant differences amongst patients with and without PAD were only observed for the three considered lipidic ratios, expressing higher values when PAD was present, and for the HDL-cholesterol, with the PAD patients reaching lower HDL levels. A multivariable logistic regression analysis was performed considering PAD as the dependent variable (dichotomized in normal/abnormal), and forcing each lipidic parameter (either individual lipis or lipid ratios) in a model adjusted for the conventional Framingham cardiovascular risk factors. Although there was an appreciable tendency of association with PAD in all lipid variables, it reaches statistical significancy only for the lipidic ratios.Conclusions:
Lipid ratios are associated with PAD over and above conventional lipid parameters in hypertensive patients, and should thus be considered in clinical decision-making and risk stratification.