Objective To analyze the correlation between low density lipoprotein cholesterol (LDL-C) and carotid plaque in patients with hypertension aged 45-64 at different blood pressure levels.Methods In this cross-sectional study,2521 subjects with hypertension were enrolled in Cardiology clinics from January 2023 to January 2024.General information,traditional risk factors for atherosclerotic cardiovascular disease,and carotid ultrasound were collected.Results In the total of patients,the mean age was 55.0±5.4 years,with men were account for 31.6％.A total of 1352 subjects (53.6％) achieved BP control,1124 subjects (44.6％) had carotid plaque.There was a positive association between LDL-C levels and the prevalence of carotid plaque.Using LDL-C≥3.4 mmol/L as reference level,and after adjusting for sex,age,duration of hypertension,smoking,BMI and diabetes history,it was found that LDL-C ranging from 2.6 to 3.39 mmol/L did not significantly reduce the risk of carotid plaque (OR=1.06,95％CI:0.81～1.39).Conversely,LDL-C＜2.6 mmol/L significantly reduced the risk of carotid plaque (OR=0.61,95％CI:0.45～0.82) in patients with hypertension who achieve BP control.Furthermore,LDL-C＜3.4 mmol/L significantly reduced the risk of carotid plaque,with a relative risk of 0.72 (95％CI:0.54～0.95) for LDL-C ranging from 2.6 to 3.39 mmol/L and 0.54 (95％CI:0.40～0.74) for LDL-C＜2.6 mmol/L in patients with hypertension who did not achieve BP control.Among the patients,542 subjects (21.5％) were treated with statins.The percentage of patients with the LDL-C level below 2.6mmol/L was 23.8％,30.6％ and 18.0％ for those with carotid plaque,diabetes mellitus or at moderate and high risk of atherosclerotic cardiovascular disease (ASCVD),respectively.Conclusions In patients with hypertension who achieved BP control,a LDL-C level＜2.6 mmol/L was associated with a lower risk of carotid plaque,while in patients who did not achieve BP control,a LDL-C level under 3.4 mmol/L correlated with a decreased risk of carotid plaque.Statin use and LDL-C control proved insufficient as the primary prevention approach for ASCVD.
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