The positive association between the atherogenic index of plasma and the risk of new-onset hypertension: a nationwide cohort study in China

ABSTRACT

Background

The atherogenic index of plasma (AIP) is a novel metabolic biomarker of atherosclerosis. Nevertheless, the association between the AIP and new-onset hypertension has not been elucidated in the Chinese population.

Methods

Prospective data were obtained from 3150 participants aged ≥ 18 years in the China Health and Nutrition Survey from 2009 to 2015. The AIP is a logarithmically transformed ratio of triglycerides to high-density lipoprotein cholesterol in molar concentration. Cox regression analysis was used to determine the association of AIP index with new-onset hypertension.

Results

After the six-year follow-up, 1054 (33.4%) participants developed new-onset hypertension. The participants were divided into AIP quartile groups (Q1-Q4). Compared with those in Q1, subjects in Q3–4 had nearly 1.35 times the risk of new-onset hypertension after full adjustment [Q3: hazard ratio (HR): 1.35, 95% confidence interval (CI): 1.13–1.62; Q4: HR: 1.35, 95% CI: 1.13–1.64]. The risks of new-onset hypertension were nearly 1.30 times higher in subjects in Q2–4 than in subjects in Q1 (p < .01) after the full adjustment when we excluded subjects with diabetes and/or chronic kidney diseases. There was a significant difference [HR (CI): 1.27 (1.04–1.54) vs. 0.90 (0.69–1.18)] when subjects were divided into two groups according to body mass index (BMI) level (<24 vs. ≥24 kg/m²).

Conclusions

The present study suggested that individuals with a higher AIP index are associated with new-onset hypertension, independent of kidney function and glucose levels. The association was stronger in subjects with normal BMI, which may provide early screening of metabolomics in hypertension prevention.

KEYWORDS:

• Blood pressure
• atherogenic index of plasma
• triglycerides
• cohort studies
• high-density lipoprotein-cholesterol

Acknowledgments

Data in this research were from the China Health and Nutrition Survey (CHNS). The authors are grateful to all subjects who participated in the nationwide population-based study. We also thank the National Institute for Nutrition and Health, China Center for Disease Control and Prevention.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

Yue Yuan collected the data, performed the statistical analysis and was charge of writing, drafting and preparation of the manuscript. Wei Sun and Xiangqing Kong were charge of conception or design, interpretation of data and revision of the manuscript. All the authors approved the final version of the manuscript.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10641963.2024.2303999

Additional information

Funding

This work was supported by the 70th batch of the China Postdoctoral Science Foundation (2021M701762), the Postdoctoral Research Program of Jiangsu Province(2021K077A) and the Doctoral Program of Entrepreneurship and Innovation in Jiangsu Province(JSSCBS20211480). Many thanks to the National Institute for Health (NIH) Fogarty program (D43 TW009077) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD, R01 HD30880; P2C HD050924) for financial support for the CHNS data collection and analysis files from 1989 to 2015 and future surveys, the China-Japan Friendship Hospital, the Ministry of Health for support for CHNS 2009, the Chinese National Human Genome Center at Shanghai since 2009, and the Beijing Municipal Center for Disease Prevention and Control since 2015.