Evidence map›Paper›PMID 42363064›Full record

ArticleBMC cardiovascular disorders2026

Association between hemoglobin A1c to HDL cholesterol ratio and hypertension in middle-aged and older Chinese adults: a cross-sectional study.

Wenqing Si, Weicheng Lai, Liangxiu Wu, Shenshen Du, Yupeng Wu, Xin Li, Wenlong Zhao, Liangyan Wu, Boda Zhou

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Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Wenqing Si *Department of Cardiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210019, China.
Weicheng Lai *Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, 102218, China.
Liangxiu Wu *Department of Gastroenterology, The People's Hospital of Hezhou, Guangxi Zhuang Autonomous Region, Hezhou, 542800, China.
Shenshen Du *Department of Nephrology, The First Affiliated Hospital of Jinan University, Guangdong, Guangzhou, 510630, China.
Yupeng WuDepartment of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.
Xin LiDepartment of Cardiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210019, China.
Wenlong ZhaoDepartment of Liver Transplantation, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, 102218, China.
Liangyan WuDepartment of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China. liangyanwu88@jnu.edu.cn.
Boda ZhouDepartment of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, 102218, China. zhouboda@tsinghua.edu.cn.ORCID https://orcid.org/0000-0001-8207-7367

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe hemoglobin A1c to high-density lipoprotein cholesterol ratio (HHR) is a novel composite index reflecting both chronic glycemic exposure and lipid metabolism. However, its association with hypertension remains unclear. This study aimed to investigate the independent association between HHR and hypertension prevalence in middle-aged and older Chinese adults.

methodsThis cross-sectional study analyzed data from the 2011 and 2015 biomarker waves of the China Health and Retirement Longitudinal Study (CHARLS). Among 25,873 initially identified participants, 11,797 were ultimately included after applying the inclusion and exclusion criteria. Multivariable logistic regression and restricted cubic spline analyses were conducted to assess the association between HHR and hypertension prevalence, adjusting for sociodemographic, lifestyle, and metabolic confounding factors.

resultsHHR was positively associated with hypertension. In the fully adjusted model, each 0.1-unit increase in HHR was associated with higher odds of hypertension (OR = 1.02, 95% CI: 1.01-1.04). Participants in the high HHR group had significantly higher odds of hypertension than those in the low HHR group (OR = 1.38, 95% CI: 1.24-1.54). Restricted cubic spline analysis showed a significant nonlinear association between HHR and hypertension.

conclusionElevated HHR was associated with hypertension in a nonlinear pattern among middle-aged and older Chinese adults. Given the cross-sectional design, these findings should be interpreted as evidence of association rather than prediction or causality. Further prospective studies are warranted to determine whether HHR provides incremental value for hypertension risk assessment.

Indexed as

Cholesterol, HDLDyslipidemiasGlycated HemoglobinHypertensionAgedAge FactorsBiomarkersChinaCross-Sectional StudiesEast Asian PeopleFemaleHumansLongitudinal StudiesMaleMiddle AgedPrevalenceBiomarkersCholesterol, HDLGlycated Hemoglobinhemoglobin A1c protein, humanCHARLSHbA1c/HDL-C ratioHypertensionPrevalence

Identifiers

PMID42363064
PMCPMC13560115

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