Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, No.91 Tianchi Road, Tianshan District, 830001, Urumqi, P.R. China.
BMC Cardiovasc Disord. 2023 Sep 11;23(1):452. doi: 10.1186/s12872-023-03451-0.
Atherogenic index of plasma (AIP), a marker of atherosclerosis and cardiovascular disease (CVD), was related to the all-cause mortality and CVD-specific mortality in a U-shape in general population respectively. However, no studies have investigated these associations in hypertensive populations. Herein, this study aims to explore the relationship of AIP and all-cause mortality and CVD-specific mortality in patients with hypertension in order to provide some reference for the risk hierarchical management of hypertension.
Demographic and clinical data of 17,382 adult patients with hypertension were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2005-2018 in this retrospective cohort study. We used weighted univariate COX regression analysis to screen the covariates, and that weighted univariate and multivariate COX regression analyses to explore the association between AIP and all-cause mortality and CVD-specific mortality with hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses of age, gender, body mass index (BMI), CVD, diabetes mellitus (DM), antihyperlipidemic agents use, and hypotensive drugs use were also performed for further exploration of these relationships.
The average follow-up time was 97.10 months. A total of 2,844 patients died, and 971 of them died due to CVD. After adjusting for age, race, education level, marital status, poverty-income ratio (PIR), smoking, BMI, physical activity, antihyperlipidemic agents, DM, CVD, hypotensive drugs, estimated glomerular filtration rate (eGFR), and total energy intake, we found that both low [HR = 1.18, 95%CI: (1.07-1.32)] and high [HR = 1.17, 95%CI: (1.03-1.33)] levels of AIP were linked to an increased risk of all-cause mortality, and the U-shape association between AIP and CVD-specific mortality was also found [low AIP level: HR = 1.26, 95%CI: (1.05-1.51); high AIP level: HR = 1.26, 95%CI: (1.06-1.49)]. Furthermore, these relationships were existed in patients whose BMI > 25, were non-Hispanic White, with non-CVD, non-DM, non-antihyperlipidemic agents, and used hypertension drug (all P < 0.05).
AIP was associated with both all-cause mortality and CVD-specific mortality in patients with hypertension, but the specific role of AIP in prognosis in hypertensive populations is needed further exploration.
血浆致动脉粥样硬化指数（AIP）是动脉粥样硬化和心血管疾病（CVD）的标志物，分别与普通人群的全因死亡率和 CVD 特异性死亡率呈 U 型相关。然而，尚无研究探讨高血压人群中这些关联。在此，本研究旨在探讨高血压患者 AIP 与全因死亡率和 CVD 特异性死亡率之间的关系，以期为高血压的风险分层管理提供参考。
本回顾性队列研究从 2005 年至 2018 年的国家健康和营养检查调查（NHANES）数据库中提取了 17382 名成年高血压患者的人口统计学和临床数据。我们使用加权单因素 COX 回归分析筛选协变量，并使用加权单因素和多因素 COX 回归分析探讨 AIP 与全因死亡率和 CVD 特异性死亡率之间的关系，以风险比（HR）和 95%置信区间（CI）表示。还进行了年龄、性别、体重指数（BMI）、CVD、糖尿病（DM）、降脂药使用和降压药使用的亚组分析，以进一步探讨这些关系。
平均随访时间为 97.10 个月。共有 2844 名患者死亡，其中 971 名死于 CVD。在校正年龄、种族、教育程度、婚姻状况、贫困收入比（PIR）、吸烟、BMI、身体活动、降脂药、DM、CVD、降压药、估计肾小球滤过率（eGFR）和总能量摄入后，我们发现低[HR=1.18，95%CI：（1.07-1.32）]和高[HR=1.17，95%CI：（1.03-1.33）]AIP 水平均与全因死亡率增加相关，并且 AIP 与 CVD 特异性死亡率之间也存在 U 型关联[低 AIP 水平：HR=1.26，95%CI：（1.05-1.51）；高 AIP 水平：HR=1.26，95%CI：（1.06-1.49）]。此外，这些关系在 BMI>25、非西班牙裔白人、非 CVD、非 DM、非降脂药和使用降压药的患者中存在（均 P<0.05）。
AIP 与高血压患者的全因死亡率和 CVD 特异性死亡率均相关，但高血压人群中 AIP 在预后中的具体作用仍需进一步探讨。
