Interaction of lipid accumulation product and family history of hypertension on hypertension risk: a cross-sectional study in the Southern Chinese population

Abstract

ObjectivesThis study aimed at investigating the applicability of a novel index based on waist circumference (WC) and triglyceride (TG) which was named lipid accumulation product (LAP) in the Southern Chinese population, and compared the predictive effects of LAP and other obesity indicators on hypertension risk. Moreover, this study investigated the interactive effects of LAP and family history of hypertension.MethodsA total number of 2079 of community-dwelling adults in Southern China were enrolled in this cross-sectional study. The participants underwent questionnaire surveys, anthropometric tests and laboratory examinations. Themultinomial logistic regression model and receiver operating characteristic curves, including LAP, body mass index (BMI), waist-to-hip ratio (WHR), WC and TG, were used to assess the association between hypertension risk and obesity indexes. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI).ResultsHigher LAP levels have a relatively higher risk of having hypertension in both sexes (males: adjusted OR=2.79 per SD increase, 95% CI 1.43 to 5.44, p<0.001; females: adjusted OR=3.15, 95% CI 1.56 to 6.39, p<0.001). LAP (area under the curve=0.721; 95% CI 0.680 to 0.761) is a better indicator in identifying hypertension risk than BMI, WHR and TG in females, but WC performed better in males. A significant interaction between LAP and family history of hypertension was observed in males (RERI=1.652, 95% CI 0.267 to 3.037; AP=0.516, 95% CI 0.238 to 0.794; SI=3.998, 95% CI 0.897 to 17.820), but there is no statistically significant difference in females.ConclusionsLAP significantly associates with hypertension risk in the Southern Chinese population. It has better performance than BMI, WHR and TG on predicting hypertension risk of the Southern Chinese female population. Moreover, LAP and family history of hypertension might synergistically increase the risk of hypertension.

The Effect of Lipid Accumulation Product and Its Interaction With Family History of Hypertension on Hypertension Risk in Population With Nondiabetic in Eastern China: A Cross-sectional Study

“…With the rapid social and economic development, the number of HTN and PHT patients in China has become considerably massive [38][39][40]. The prevalence of HTN (24.8%) in our study was consistent with that survey conducted in Zhejiang province (24.59%) [41], higher than that in Guangdong province (22.03%) [19]. Also, the overall prevalence of PHT in this study was 37.1%, higher than that results carried out in Jiangxi province (32.3%) [9] and Zhejiang province (32.1%) [41], but lower than the rates in Qinghai province (41.3%) [11] and Hubei province (42.2%) [39].…”

“…However, when it comes to obesity, body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) are most common indexes to assess obesity [17]. BMI can re ect the degree of overweight and obesity, but cannot differentiate the abdominal obesity [18], WC and WHtR can re ect the abdominal fat distribution, but cannot distinguish between visceral and subcutaneous fat [19]. Nevertheless, HTN and other cardiovascular risks are directly determined by visceral fat rather than subcutaneous fat [20].…”

“…LAP had also been shown to predict blood pressure in 21,572 Japanese men [28]. Several studies in China also have investigated the association between LAP and HTN [19,29], as a largest developing country in the world, China has faced rapid economic development and met huge social medical burdens. Anhui province, located in the east of China, has experienced rapid aging process, unhealthy diet intake, physical inactivity and so on.…”

Age-adjusted cut-off values of lipid accumulation product (LAP) for predicting hypertension

“…Song et al noted that the best thresholds of LAP to predict hypertension were 29.14 cm mmol /l in women and 40.60 cm mmol /l in men 9 . Huang et al showed that the cut-off values of LAP for identifying hypertension were 30.86 cm mmol /l in women and 63.89 cm mmol /l in men 11 . In these two studies, the cut-off points of LAP were higher in men than in women.…”

“…The cut-off values of LAP for hypertension obtained in some studies are very different. Reported LAP cut-off values ranged from 25.16 to 31.59 cm mmol/l for women and from 20.10 to 63.89 cm mmol /l for men [9][10][11][12] . These discrepancies may be due to differences in sample populations with regard to age range, race/ethnicity, criteria for screening hypertension, and health status of the control group.…”