A cohort study of atherogenic index of plasma and the risk of cardiovascular disease in community elderly hypertensive population of Kunshan area

Objective To investigate the relationship between plasma atherosclerosis index (AIP) and the risk of cardiovascular disease in community elderly hypertensive patients in Kunshan area.

Methods A total of 21, 226 elderly hypertensive patients who underwent annual health examinations in community were enrolled in this study. Demographic information such as baseline age, gender, smoking history, hypertension, diabetes, and history of cardiovascular disease were collected. Patients' height, body weight, body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, and blood lipids were measured. Lipid indicators including AIP, lipid composite index (LCI), Castelli risk index-Ⅰ (CRI-Ⅰ), and Castelli risk index-Ⅱ(CRI-Ⅱ) were recorded. The primary endpoint was the first occurrence of cardiovascular disease. The multivariate Cox proportional hazards model was used to explore the relationship between baseline AIP level and cardiovascular disease risk in hypertensive patients.

Results After a median follow-up period of 5.62 (3.53, 7.16) years, 3, 179 patients occurred cardiovascular disease events. Cox regression analysis showed that a higher baseline AIP level was positively correlated with cardiovascular disease risk without adjusting for confounding factors (HR=1.16; 95%CI, 1.02 to 1.32). After further adjustment for age, gender, BMI, waist circumference, blood pressure, blood glucose, smoking history, and diabetes history, the AIP level remained closely related to cardiovascular disease risk. Restricted cubic spline analysis suggested an overall linear relationship between AIP and cardiovascular disease risk. Kaplan-Meier survival curve analysis showed that compared with the lowest quartile, the cumulative risk of cardiovascular disease was higher in the highest quartile (P < 0.001).

Conclusion In community elderly hypertensive patients in Kunshan area, baseline AIP level is associated with cardiovascular disease risk. Monitoring AIP levels may aid in predicting and assessing the risk of cardiovascular disease.