Abstract
BACKGROUND: Atherosclerosis is recognized as a potential etiological factor for hypertension. However, evidence regarding the association between the Atherogenic Index of Plasma (AIP) and hypertension in Chinese middle-aged and older adults remains limited. This study aimed to examine the association between AIP and hypertension in this population. METHODS: This retrospective single-center cross-sectional study consecutively enrolled 5,254 participants undergoing routine health examinations at the Health Management Center of Union Hospital Affiliated to Huazhong University of Science and Technology (Wuhan, China) between January 2017 and December 2019. Among them, 1,799 were diagnosed with hypertension and 579 with diabetes mellitus. The association between AIP and hypertension was analyzed using logistic regression and restricted cubic splines (RCS). Stratified analyses were performed by diabetes status. Furthermore, mediation analysis was conducted to evaluate the mediating effect of body mass index (BMI) on the AIP and hypertension association. RESULTS: In this cross-sectional study of 5,254 participants, a positive association was observed between the atherogenic index of plasma (AIP) and hypertension. After adjusting for multifactorial confounders, each 1-unit increment in AIP was associated with a 14% higher odds of hypertension (aOR = 1.14, 95% CI: 1.02-1.27). Mediation analysis confirmed that body mass index (BMI) partially mediated this association, accounting for 55.62% of the total effect (p < 0.001). CONCLUSION: These findings suggest that elevated AIP is independently and positively associated with hypertension prevalence in adults aged ≥45 years, with body mass index (BMI) mediating 55.62% of this association (p < 0.001).