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Association between NHHR and depression symptoms among U.S. adults with hypertension: a cross sectional

Jie Lu1, Xiaojing Zheng2

  • 1Gansu University of Traditional Chinese Medicine, Lanzhou, China.

BMC Cardiovascular Disorders
|May 19, 2026
PubMed

Insights

The non-HDL cholesterol to HDL cholesterol ratio (NHHR) shows a U-shaped link with depressive symptoms in hypertensive adults. This lipid marker may indicate depression risk in this population.

Area of Science:

  • Cardiovascular Disease Research
  • Lipid Metabolism Studies
  • Mental Health and Physiology

Background:

  • The non-HDL cholesterol to HDL cholesterol ratio (NHHR) is a key lipid marker for cardiovascular disease risk.
  • Previous research links lipid metabolism and depressive symptoms, with hypertension as a potential factor.
  • This study investigates the NHHR-depression link in hypertensive patients.

Purpose of the Study:

  • To examine the association between the non-HDL cholesterol to HDL cholesterol ratio (NHHR) and clinically significant depressive symptoms.
  • To explore this relationship in adult patients diagnosed with hypertension in the United States.

Main Methods:

  • Utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2007-2018.
  • Assessed depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) in 10,754 US adults (≥18 years).
  • Employed logistic regression, curve analysis, and threshold modeling to analyze NHHR and depressive symptoms.

Main Results:

  • A U-shaped relationship was observed between NHHR and depressive symptoms.
  • A threshold of 1.25 for log-transformed NHHR was identified.
  • Below 1.25, NHHR was negatively correlated with depression (OR=0.19); above 1.25, it was positively correlated (OR=1.14).

Conclusions:

  • A U-shaped association exists between NHHR and depressive symptoms in US adults with hypertension.
  • NHHR can be a concise indicator for depressive symptoms in hypertensive individuals.
  • Further research on NHHR may offer novel insights into depressive symptom research in this demographic.
Abstract

Keywords:
Cross-sectional studyDepressive symptomsHypertensionNHANESNHHR

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