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

Figures & data

Figure 1. Flowchart of the study participants enrolled from the China health and nutrition survey (n = 3510).

Table 1. Characteristics of the study participants at baseline and during follow-ups.

Characteristics	Overall	Quartiles of AIP index				P value
		Q1(≤ −0.28)	Q2(>-0.28 to −0.08)	Q3(>-0.08 to 0.15)	Q4(>0.15)
n	3150	780	779	814	777
2015
Age, years	56.00(47.0–65.0)	54.0(45.0–64.0)	56.0(47.0–66.0)	56.0(47.0–65.0)	56.0(48.0–65.0)	0.056
Male,(%)	1317(41.8)	284(36.4)	311(39.9)	346(42.5)	376(48.4)	<0.001
SBP, mmHg	124.67(116.00–137.33)	121.33(112.00–132.00)	124.33(114.67–136.00)	126.67(118.00–140.00)	128.00(118.67–138.00)	<0.001
DBP, mmHg	80.00(73.33–86.00)	79.33(71.33–84.00)	.80.00(72.67–85.00)	80.00(75.33–86.00)	80.67(75.33–87.33)	<0.001
MAP, mmHg	94.67(88.87–102.00)	93.33(86.89–100.00)	94.22(88.00–101.11)	95.56(90.00–103.03)	96.00(90.00–103.33)	<0.001
BMI, kg/m2	23.56(21.39–25.91)	22.25(20.33–24.57)	23.10(21.09–25.21)	23.97(21.91–26.50)	24.95(22.96–27.09)	<0.001
WHR	0.88(0.84–0.93)	0.85(0.81–0.91)	0.88(0.83–0.93)	0.89(0.84–0.93)	0.91(0.87–0.95)	<0.001
Smoking, n(%)	783(24.9)	166(21.3)	184(23.6)	213(26.2)	220(28.3)	0.009
Drinking, n(%)	791(25.1)	204(26.2)	169(21.7)	196(24.1)	222(28.6)	0.013
Urban residance,(%)	953(30.3)	229(29.4)	227(29.1)	251(30.8)	246(31.7)	0.656
Education years	9.00(9.00–12.00)	9.00(9.00–12.00)	9.00(6.00–12.00)	9.00(9.00–12.00)	9.00(6.00–12.00)	0.018
Marital status						0.579
married	2849(90.4)	714(91.5)	700(89.9)	744(91.4)	691(88.9)
divorced	31(1.0)	8(1.0)	8(1.0)	6(0.7)	9(1.2)
Single and others	270(8.6)	58(7.4)	71(9.1)	64(7.9)	77(9.9)
2009
AIP index	−0.08(−0.28–0.15)	−0.40(−0.51—-0.34)	−0.17(−0.23—-0.12)	0.02(−0.03–0.08)	0.35(0.24–0.51)	<0.001
SBP, mmHg	124.67(116.00–137.33)	115.00(108.00–121.33)	118.67(110.00–124.00)	119.33(110.00–126.00)	120.00(111.33–126.67)	<0.001
DBP, mmHg	80.00(73.33–86.00)	76.00(70.00–80.00)	77.33(70.00–80.67)	78.67(70.67–81.00)	80.00(74.67–82.00)	<0.001
MAP, mmHg	94.67(88.89–102.00)	89.11(82.94–93.72)	90.67(83.33–95.11)	91.50(85.33–95.56)	93.33(88.00–96.67)	<0.001
BMI, kg/m2	23.56(21.39–25.91)	21.37(19.63–23.33)	22.06(20.28–24.22)	23.43(21.40–25.65)	24.43(22.26–26.47)	<0.001
WHR	0.88(0.84–0.93)	0.84(0.80–0.89)	0.86(0.81–0.90)	0.87(0.82–0.91)	0.90(0.85–0.93)	<0.001
Urea, mmol/L	5.29(4.37–6.31)	5.40(4.36–6.45)	5.20(4.33–6.23)	5.14(4.28–6.21)	5.37(4.56–6.38)	0.005
Serum uric acid, mmol/L	281.00(231.00–344.00)	249.00(201.00–301.00)	268.00(221.00–318.00)	281.50(236.75–341.25)	338.00(282.00–414.00)	<0.001
Creatinine, mmol/L	84.00(75.00–94.00)	81.00(74.00–91.00)	82.00(74.00–94.00)	84.00(76.00–95.00)	87.00(76.00–96.00)	<0.001
HDL-C, mmol/L	1.41(1.19–1.65)	1.72(1.51–2.00)	1.50(1.33–1.68)	1.34(1.19–1.50)	1.11(0.97–1.28)	<0.001
LDL-C, mmol/L	2.89(2.33–3.46)	2.69(2.23–3.20)	2.98(2.44–3.49)	3.09(2.52–3.69)	2.87(2.21–3.50)	<0.001
TC, mmol/L	4.74(4.16–5.40)	4.53(3.98–5.14)	4.66(4.10–5.25)	4.76(4.19–5.45)	5.03(4.41–5.73)	<0.001
Triglycerides, mmol/L	1.20(0.83–1.81)	0.65(0.54–0.78)	1.00(0.88–1.15)	1.43(1.22–1.64)	2.63(2.08–3.48)	<0.001
Hemoglobin A1c, %	5.50(5.20–5.80)	5.40(5.10–5.70)	5.40(5.20–5.70)	5.50(5.20–5.80)	5.60(5.30–5.90)	<0.001
Total protein, g/L	76.90(73.60–80.30)	76.60(73.50–80.20)	77.00(73.70–80.20)	77.30(74.00–80.80)	76.60(73.25–79.90)	0.038
Albumin, g/L	47.20(45.10–49.30)	46.80(44.80–48.80)	46.90(45.00–49.20)	47.30(45.10–49.30)	47.70(45.60–49.90)	<0.001
Fasting plasma glucose, mmol/L	5.08(4.69–5.54)	4.93(4.59–5.28)	5.00(4.62–5.42)	5.08(4.73–5.55)	5.38(4.92–6.00)	<0.001
Alanine Aminotransferase, U/L	18.00(13.00–26.00)	16.00(12.00–22.00)	16.00(12.00–22.00)	19.00(14.00–26.00)	23.00(16.00–35.00)	<0.001
Apolipoprotein A, mmol/L	1.10(0.95–1.29)	1.20(1.05–1.41)	1.13(0.99–1.30)	1.07(0.94–1.25)	1.01(0.87–1.18)	<0.001
Apolipoprotein B, mmol/L	0.87(0.72–1.05)	0.75(0.62–0.87)	0.85(0.72–1.00)	0.93(0.77–1.10)	1.01(0.82–1.17)	<0.001
eGFR, ml/min/1.73 m^2	81.54(72.90–90.90)	83.31(74.45–93.29)	81.61(73.29–91.30)	80.98(77.27–90.07)	80.28(71.63–89.30)	<0.001

Abbreviations: AIP, atherogenic index of plasma; SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; BMI, body mass index; WHR, waist to hip ratio; HDL-C, high-density lipoprotein cholesterol, LDL-C, low-density lipoprotein cholesterol; TC, total cholesterol; eGFR,Estimated Glomerular Filtration Rate; Non-normally distributed variables are expressed as the median (interquartile range). All other values are expressed as mean ± SD or n, %.

Table 2. The association of AIP index with new-onset hypertension.

AIP index	Total N	No. of events (^aincident rate)	HR	P value	Model 1	P value	Model 2	P value
Quartiles
Q1 (≤ −.28)	780	216(49.3)	Ref.		Ref.		Ref.
Q2 (> −.28 to − .08)	779	242(57.3)	1.16(0.96–1.39)	.123	1.14(0.95–1.37)	.153	1.14(0.94–1.37)	.177
Q3 (>-.08 to .15)	814	305(70.0)	1.41(1.18–1.68)	<.001	1.39(1.16–1.65)	<.001	1.35(1.13–1.62)	.001
Q4 (>.15)	777	291(71.9)	1.44(1.21–1.72)	<.001	1.40(1.17–1.67)	<.001	1.35(1.11–1.64)	.002
P for trend				<.001		<.001		.001
Quartiles
Q1 (≤ −.28)	780	216(49.3)	Ref.		Ref.		Ref.
Q2 (> −.28)	2370	838(66.3)	1.34(1.15–1.55)	<.001	1.31(1.13–1.52)	<.001	1.27(1.09–1.48)	.003
Continuous
Per 1.0 increase	3150	1054(62.0)	1.49(1.25–1.77)	<.001	1.46(1.23–1.74)	<.001	1.47(1.19–1.82)	<.001

AIP, atherogenic index of plasma.

Model 1: adjusted for gender, age ,marital status, smoking, alcohol drinking, province, diabetes history.

Model 2 (full model): Model 1+ further adjusted for creatine, urea, total protein, fasting blood glucose, eGFR.

^aIncident rate was presented as per 1000 person-years of follow-up.

Figure 2. Stratified analyses by potential modifiers of the association between AIP index and new-onset hypertension. AIP, atherogenic index of plasma; Q, quartile; HR hazard ratio; CI, confidence interval; ref, reference; WHR, waist hip ratio; CKD, chronic kidney disease; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure.

^aIncident rate was presented as per 1000 person-years of follow-up. The model was adjusted for, if not stratified, sex, age, WHR, smoking, drinking, urban resistance, marital status, education, diabetes mellitus, uric acid, total protein, fasting glucose, blood urea nitrogen, estimated glomerular filtration rate (eGFR).