Association Between Cholesterol Levels, Blood Pressure and Coronary Heart Disease Risk: A Secondary Data Analysis

Abstract

Coronary heart disease (CHD) remains a major global health concern, with elevated cholesterol and blood pressure contributing significantly to cardiovascular risk. This study investigated the associations between total cholesterol, blood pressure, and recorded 10-year CHD outcomes while evaluating their contributions to risk prediction. A secondary observational analysis was conducted using 4,240 participant records. Descriptive statistics, Welch’s t-tests, and Pearson chi-square tests were employed to examine cardiovascular risk factors and CHD occurrence. Multivariable logistic regression estimated adjusted odds ratios (aORs), while five-fold stratified cross-validation assessed predictive discrimination using the area under the receiver operating characteristic curve (AUC). CHD events were recorded in 644 participants (15.2%). Event proportions increased from 10.5% to 17.8% across cholesterol categories and from 8.5% to 30.8% across systolic blood pressure categories. Multivariable analysis identified total cholesterol (aOR = 1.089 per 40 mg/dL), systolic blood pressure (aOR = 1.407 per 20 mmHg), age, male sex, current smoking, and diabetes as significant predictors. The combined cholesterol–systolic blood pressure model achieved an AUC of 0.728, compared with 0.709 for the baseline model. These findings demonstrate that cholesterol and blood pressure provide complementary information for CHD risk assessment. However, the modest improvement in predictive discrimination and absence of external validation warrant cautious interpretation before clinical application.