Lipid Accumulation Product and Hypertension Related to Stroke: a 9.2-Year Prospective Study Among Mongolians in China

Abstract

Aims: We aimed to assess the relationship between lipid accumulation product (LAP) and stroke incidence and whether increased LAP would further enlarge the risk of stroke in participants with hypertension in an Inner Mongolian population of China.

Methods: Based on the baseline survey conducted in 2002-2003, a prospective cohort study was conducted among 2547 Mongolian people from Inner Mongolia, China. LAP was calculated by waist circumference (WC) and triglyceride (TG) concentration for men and women, respectively. Cox proportional hazards models and receiver operating characteristic (ROC) curves were used to evaluate the associations between LAP, hypertension, and stroke incidence.

Results: During the follow-up period, a total of 121 stroke events were observed. Participants with higher LAP were associated with higher risk of stroke [adjusted hazard ratio (HR), 1.67; 95% confidence interval (CI), 1.08-2.58] than the participants in the lower LAP group. However, no significant dose-response relationship was detected between LAP levels and risk of stroke (P-trend=0.103). The Kaplan-Meier curves showed that hypertensives with high LAP had highest cumulative stroke incidence rate (log-rank P ＜0.001). The multivariate-adjusted HRs (95% CIs) of stroke for normotensives with high LAP, hypertensives with low LAP, and hypertensives with high LAP were 1.80 (0.84-3.89), 2.94 (1.51-5.74), and 4.23 (2.15-8.34), respectively, compared with normotensives with low LAP.

Conclusions: The present study showed that high LAP was associated with an increased risk of future stroke, and hypertensives with high LAP had the highest risk of stroke among Inner Mongolians. These findings indicate that LAP and hypertension may be valuable to predict and prevent stroke incidence.

Fig. 1.

Cumulative incidence curve of stroke according to hypertensive status and LAP.

Fig. 2.

Area under the curve for the prediction of stroke according to hypertension/high LAP and other conventional factors. Other conventional factors include age, sex, BMI, smoking and drinking statuses, family history of CVD, levels of fasting glucose (normoglycemia, impaired fasting glucose, or diabetes mellitus), total cholesterol, and HDL-C.