Association of HDL-Cholesterol, hypertension and left ventricular hypertrophy in youths with overweight or obesity.

To evaluate the relationship between HDL-Cholesterol (HDL-C), hypertension, and left ventricular hypertrophy (LVH) in a large sample of Caucasian youths with overweight/obesity (OW/OB). A cross-sectional multicenter study was performed in 1469 youths (age 6–16 years) with OW/OB observed in the period 2016–2020. An additional independent sample of 244 youths with an echocardiographic evaluation, observed in a single center was analyzed. The sample was divided in six quantiles (Q) of HDL-C: Q1: >56, Q2: ≤56 > 51, Q3: ≤51 > 45, Q4: ≤45 > 41, Q5: ≤41 > 39, Q6: <39 mg/dL. The nadir of the relationship was identified in youths in the first quantile. Among HDL-Cholesterol quantiles the distribution of hypertension was non-linear with a percentage of 25.0%, 40.1%, 33.6%, 31.3%, 35.2% and 39.7% in the six quantiles, respectively. The percentage of LVH was 21.8%, 43.6%, 48.8%, 35.5%, 38.5% and 52.0% in the six quantiles, respectively. The highest odds [95%Cl] of hypertension were 2.05 (1.33–3.16) (P < 0.01) in Q2, 1.67 (1.10–2.55) (P < 0.05) in Q3 and 1.59 (1.05–2.41) (P < 0.05) in Q6 vs Q1. The odds of LVH were 3.86 (1.15–10.24) (P < 0.05) in Q2, 4.16 (1.58–10.91) (P < 0.05) in Q3 and 3.60 (1.44–9.02) (P < 0.05) in Q6 vs Q1, independently by centers, age, sex, prepubertal stage, and body mass index. Contrary to the common belief, the present study shows that high levels of HDL-C may be not considered a negative predictor of hypertension and LVH, two risk factors for future CV disease. • Association between HDL-Cholesterol and cardiovascular risk is non-linear in adults. • Whether a similar slope is present in youths with obesity is unexplored. • 1469 youths with obesity were stratified across six quantiles of HDL-Cholesterol. • A U-shaped curve between HDL-Cholesterol quantiles and hypertension was found. • Targeting only low HDL-Cholesterol as a risk factor may be misleading. [ABSTRACT FROM AUTHOR]