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. 2022 Jun 23:2022:4914791.
doi: 10.1155/2022/4914791. eCollection 2022.

Associations of the Cardiometabolic Index with the Risk of Cardiovascular Disease in Patients with Hypertension and Obstructive Sleep Apnea: Results of a Longitudinal Cohort Study

Xintian Cai  1 , Junli Hu  1 , Wen Wen  1 , Jingyu Wang  2 , Mengru Wang  1 , Shasha Liu  1 , Qing Zhu  1 , Jing Hong  1 , Yujie Dang  1 , Xiaoguang Yao  1 , Le Sun  1 , Delian Zhang  1 , Qin Luo  1 , Nanfang Li  1
Affiliations

Associations of the Cardiometabolic Index with the Risk of Cardiovascular Disease in Patients with Hypertension and Obstructive Sleep Apnea: Results of a Longitudinal Cohort Study

Xintian Cai et al. Oxid Med Cell Longev. .

Abstract

Purpose: We aimed to explore the relationship between the cardiometabolic index (CMI) and cardiovascular disease (CVD) and its subtypes (coronary artery disease and stroke) in patients with hypertension and obstructive sleep apnea (OSA).

Methods: We conducted a retrospective cohort study enrolling 2067 participants from the Urumqi Research on Sleep Apnea and Hypertension study. The CMI was calculated as triglyceride to high-density lipoprotein cholesterol ratio × waist-to-height ratio. Participants were divided into three groups (T1, T2, and T3) according to the tertile of CMI. The Kaplan-Meier method helped to calculate the cumulative incidence of CVD in different groups. We assessed the association of CMI with the risk of CVD and CVD subtypes by estimating hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models.

Results: During a median follow-up of 6.83 years (interquartile range: 5.92-8.00 years), 326 incident CVD were identified, including 121 incident stroke and 205 incident coronary heart disease (CHD). Overall, after adjusting for confounding variables, CMI was positively associated with the risk of new-onset CVD (per SD increment, adjusted HR: 1.31; 95% CI: 1.20, 1.43), new-onset CHD (per SD increment, adjusted HR: 1.33; 95% CI: 1.20, 1.48), and new-onset stroke (per SD increment, adjusted HR: 1.27; 95% CI: 1.10, 1.47). Similar results were obtained in various subgroup and sensitivity analyses. Adding CMI to the baseline risk model for CVD improved the C-index (P < 0.001), continuous net reclassification improvement (P < 0.001), and integrated discrimination index (P < 0.001). Similar results were observed for CHD and stroke.

Conclusion: There was a positive association between CMI levels and the risk of new-onset CVD in patients with hypertension and OSA. This finding suggests that CMI may help identify people at high risk of developing CVD.

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Conflict of interest statement

The authors deny any conflict of interest with this manuscript.

Figures

Figure 1
Figure 1
Flow chart of study participant selection.
Figure 2
Figure 2
Cumulative hazards of risk of (a) cardiovascular disease, (b) coronary heart disease, and (c) stroke according to the tertile of the cardiometabolic index.
Figure 3
Figure 3
Smoothing curve revealing the effect of the cardiometabolic index on the risk of (a) cardiovascular disease, (b) coronary heart disease, and (c) stroke. ∗Adjusted for all noncollinear variables.
Figure 4
Figure 4
Association of the cardiometabolic index (per SD increment) with risk of (a) cardiovascular disease, (b) coronary heart disease, and (c) stroke in various subgroups. ∗Adjusted for all noncollinear variables, if not be stratified.
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