The association between atherogenic index of plasma and cardiovascular disease in hypertension: a cross-sectional and longitudinal study

Background

The use of low-density lipoprotein (LDL)-lowering drugs has reduced cardiovascular disease (CVD) risk significantly, but residual risk from dyslipidemia remains. Thus, exploring comprehensive lipid indices to assess and predict the impact of the lipid profile on CVD is necessary.

Objective

This study intends to explore the association of atherogenic index of plasma(AIP) with CVD in hypertension.

Methods

This post hoc analysis used data from the Systolic Blood Pressure Intervention Trial (SPRINT). Logistic regression and Cox proportional hazards regression were applied to explore the relationship between AIP and CVD, with subgroup analyses conducted. Non-linear relationships were also examined through trend analysis.

Results

In the cross-sectional study (n = 9323), AIP was positively correlated with clinical CVD(OR, 1.58 [95 %CI, 1.23, 2.04]), and the trend tests were significant(p<0.05). This positive association exists in different subgroups. In the longitudinal study(n = 8458), AIP was significantly and positively correlated with primary outcome(HR 1.62, 95 %CI 1.15, 2.27), CVD death(HR 2.45, 95 %CI 1.04, 5.77), myocardial infarction(HR 1.97, 95 %CI 1.15, 3.37) and peripheral arterial disease(HR 2.52, 95 %CI 1.31, 4.87). Trend tests were significant for the primary outcome, myocardial infarction, and peripheral arterial disease (p < 0.05), with positive correlations observed across most subgroups.

Conclusion

The level of AIP is positively correlated with clinical CVD in cross-sectional study. Moreover, in the longitudinal study, the higher the level of AIP, the greater the risk of subsequent adverse cardiovascular events(primary outcome). This positive correlation exists independently of MI and PAD events.