High NHHR associated with increased carotid plaque risk in adults without baseline plaque

This retrospective cohort study enrolled 5,985 adults aged ≥18 years without baseline carotid plaque from the Dalian Health Management Cohort. The primary exposure was the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR), categorized into quartiles, with the lowest NHHR quartile serving as the comparator. The primary outcome was the development of carotid plaque (CP) over a follow-up period of 11,725.34 person-years, with a mean follow-up of 2.24 years.

Participants in the highest NHHR quartile experienced a significantly increased risk of carotid plaque compared with those in the lowest NHHR quartile. Specifically, 780 participants (13.03%) developed CP. The hazard ratio for this association was 1.64, with a 95% confidence interval of 1.26–2.14. No secondary outcomes were reported.

Safety and tolerability data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. Funding sources and conflicts of interest were not reported. The study design limits causal inference, and the findings reflect an association rather than a proven causal relationship.