Nutrition, Metabolism, and Cardiovascular Diseases · Nov 2026
Cumulative residual triglyceride exposure associates with arterial stiffness progression independent of low-density lipoprotein cholesterol
By Li Y, Chen K, Yan L et al.
Background and aims Residual cardiovascular disease (CVD) risk persists even when low-density lipoprotein cholesterol (LDL-C) is below guideline thresholds. The association between residual triglyceride (TG) levels and progression of arterial stiffness, an independent CVD risk factor, remains insufficiently explored, especially in populations with well-controlled LDL-C. Methods and results This retrospective cohort study included 2,982 adults at low-to-moderate cardiovascular risk with LDL-C at target and at least three TG measurements, enrolled between 2017 and 2024 at the Third Xiangya Hospital, Hunan (mean follow-up, 4.0 years). Arterial stiffness progression was assessed by brachial-ankle pulse wave velocity (baPWV), including absolute change, rate of change, and slope. Residual TG was defined as measured TG minus 150 mg/dL and time-averaged across visits. Time-averaged residual TG was linearly and positively associated with baPWV change, rate of change, and slope in fully adjusted linear regressions (per 50 mg/dL increment: β = 8.966 cm/s, 2.039 cm/s/year, and 2.116 cm/s/year, respectively; all P < 0.001). Participants in the highest residual TG quartile showed greater increases in baPWV change (35.918 cm/s) and slope (8.203 cm/s/year) than those in the lowest quartile (Bonferroni-adjusted P = 0.021 and 0.039), with significant linear trends for all outcomes (P for trend = 0.010–0.035). Participants with residual TG risk had a greater baPWV change (β = 28.400 cm/s, P = 0.003), and the continuous association persisted in a lagged-exposure analysis. Conclusions Persistent hypertriglyceridemia (time-averaged TG >150 mg/dL) is associated with arterial stiffness progression in adults at low-to-moderate cardiovascular risk, independent of LDL-C goal attainment.