A nonlinear relationship between low-density-lipoprotein cholesterol levels and atrial fibrillation among patients with hypertension in China

Jia Yi Huang, Lin Liu, Yu Ling Yu, Chao Lei Chen, Kenneth Lo, Bin Zhang, Song Tao Tang, Yu Qing Huang, Ying Qing Feng

Research output: Journal article publicationJournal articleAcademic researchpeer-review


Background: The association between low-density-lipoprotein cholesterol (LDL-C) and atrial fibrillation (AF) in hypertensive population remains controversial. Therefore, we explored the relationship between LDL-C and AF among patients with hypertension in a Chinese community. Methods: This is a retrospective cross-sectional study that enrolled 7,808 hypertensive patients between January 2013 and December 2013 in Guangdong, China. AF was diagnosed by 12-lead electrocardiogram (ECG) or self-reported status. LDL-C value were categorized by quartiles. Univariate and multivariate logistic regression were performed to examine the relation between LDL-C and AF. LDL-C values were expressed in continuous (every 1 mg/dL increment) or categorical variables in each regression model. Results: Among 7,808 (47.1% man, with mean age 62.3 years) participants, 78 AF cases were identified. In multivariate logistic regression, when LDL-C was presented as continuous variable, it was inversely associated with the occurrence of new onset AF (OR =0.99, 95% CI: 0.98, 1.00; P=0.018). Meanwhile, when LDL-C was presented as categorical variable, the negative association between LDL-C and AF was attenuated after adjusting for confounders. Adjusted restricted cubic spline demonstrated a non-linear correlation between LDL-C and AF. Conclusions: Lower levels of LDL-C was associated with increased incidence of AF in a Chinese community hypertensive population.

Original languageEnglish
Pages (from-to)2953-2961
Number of pages9
JournalAnnals of Cardiothoracic Surgery
Issue number5
Publication statusPublished - 1 Sep 2020
Externally publishedYes


  • Atrial fibrillation (AF)
  • Hypertension
  • Low-density-lipoprotein cholesterol

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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