The Association of Cumulative Chinese Visceral Adiposity Index and New-Onset Hypertension in Middle-Aged and Elderly Chinese Populations: A Cohort Study

Abstract

Introduction: Previous studies have reported a significant relationship between the baseline Chinese visceral adipose index (CVAI) and the risk of new-onset hypertension (NOH). However, the long-term effect of the CVAI and the risk of NOH remains uncertain. This study aimed to investigate the association between the cumulative CVAI and the risk of NOH.

Methods: Data were obtained from the China Health and Retirement Longitudinal Study from 2011 to 2020. In total, 2,836 Chinese participants ≥45 years were included. Multivariable logistic regression analysis as well as restricted cubic spline regression analysis were performed to assess the association of the cumulative CVAI, visceral adiposity index (VAI), and lipid accumulation product (LAP) with the risk of NOH. Furthermore, receiver operating characteristic (ROC) curve analysis was used to determine the area under the ROC curves between the risk of NOH and the adiposity indices to compare the predictive powers of the cumulative CVAI, VAI, and LAP for NOH.

Results: During the 5-year follow-up period, 433 cases of NOH were recorded. The cumulative CVAI, VAI, and LAP were positively associated with the risk of NOH. After adjusting for potential confounders, as compared to the lowest quartile of the cumulative CVAI, VAI, and LAP, the participants in the highest quartile had a significantly higher risk for NOH (odds ratio = 1.74, 1.46, and 1.95; 95% confidence interval = 1.25-2.42, 1.05-2.03, and 1.39-2.75, respectively). ROC analysis revealed that the cumulative CVAI had the highest relationship with the risk of NOH.

Conclusion: The cumulative CVAI was positively associated with an increased risk of NOH in middle-aged and elderly Chinese populations. In addition, the performance of the cumulative CVAI to predict NOH was superior to other visceral obesity indices. Monitoring long-term changes to the CVAI may assist with early identification of individuals at high risk of NOH.

Keywords: China Health and Retirement Longitudinal Study; Chinese visceral adiposity index; Cumulative exposure; New-onset hypertension; Visceral obesity.