Association Between Neutrophil to High-Density Lipoprotein Cholesterol Ratio and Heart Failure: A Cross-Sectional...

To explore the association between high-density lipoprotein cholesterol ratio (NHR) and the prevalence of heart failure (HF).

Data from National Health and Nutrition Examination Survey (1999-2018) were downloaded. Unweighted multivariate logistic regression model evaluated whether NHR levels were independently related to HF, adjusting for demographics and clinical variables. Subgroup analyses examined consistency across populations. The nonlinear relation between NHR and HF was appraised by restricted cubic spline (RCS), with inflection point identified by two-piece linear regression.

The study included 41,449 participants, of whom 1322 (3.19%) were diagnosed with HF. Analyzing NHR as a continuous variable, multivariable-adjusted logistic regression analysis demonstrated a significant independent relationship between elevated NHR levels and HF risk (OR = 1.08; 95% CI: 1.04-1.12; p < 0.001). When NHR was stratified by quartiles, the risk of HF was 1.94 times higher (95% CI: 1.56-2.41; p < 0.001) for individuals in the highest NHR quartile compared to those in the lowest quartile. RCS analysis indicated a notable nonlinear relationship (p-nonlinear < 0.001), with a threshold effect identified at an NHR of 6.39. A 21% higher risk of HF was associated with each unit increase in NHR below this turning point. In subgroup analyses, it was shown that the connection between NHR and HF was noticeable across both males and females, in participants with and without hypertension, in those with and without diabetes, and certain racial groups (Non-Hispanic Whites, Non-Hispanic Blacks, and other races).

The increased NHR was correlated with a heightened prevalence of HF.