ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1574125
Sex-specific differences in the relationship between the atherogenic index and hypertension in middle-aged and elderly Chinese
Provisionally accepted
- 1The Second Affiliated Hospital of Nanchang Universi, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, China
- 2Nanchang University, Nanchang, China
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Background: Despite the already comprehensive epidemiological evidence concerning pre-hypertension, high-normal blood pressure, and hypertension, the influence of gender differences within this context remains inadequately explored. The present study endeavors to meticulously examine the specific impact of the plasma atherogenic index (AIP) on pre-hypertension and hypertension, and ascertain whether there exist significant sex-specific differences in this regard.This population-based study employed a multi-wave cohort design encompassing 8255 middle-aged and elderly participants (cross-sectional phase) and longitudinal follow-ups in 2015 (n=8092) and 2018 (n=7022).Participants were stratified into normotensive (n=3175 in cross-sectional, n=2415 in 2015 longitudinal cohort study, 1868 in 2018 longitudinal cohort study) and prehypertensive/hypertensive groups (n=5080 (61.5%) in cross-sectional study, n=5677(70.2%) in longitudinal study of 2015, n=5336(76.0%) in 2018). The plasma atherogenic index=log10(triglycerides/high-density lipoprotein)[triglycerides (mg/dL)/HDL-C (mg/dL)]) was quantified enzymatically. Multivariable-adjusted logistic regression models with restricted cubic splines were implemented to evaluate nonlinear associations between AIP and blood pressure status, adjusting for age, sex, BMI, smoking, and lipid-lowering therapy. Sensitivity analyses included multiple imputation for missing covariates and sex-stratified effect modification testing.Results: This epidemiological investigation revealed population prevalences of 34.3% for pre-hypertension and 27.2% for hypertension. Both cross-sectional and longitudinal analyses demonstrated a significant positive association between AIP index and blood pressure dysregulation. Adjusted logistic regression models showed that elevated AIP corresponded to increased risks of pre-hypertension/hypertension, with cross-sectional analyses yielding an odds ratio (OR) of 1.
Keywords: Atherogenic index of plasma, Sex-specific differences, female, Hypertension, Pre-hypertension
Received: 10 Feb 2025; Accepted: 28 May 2025.
Copyright: © 2025 Zhang, Wang, Kong, Li, Bao, Tu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jian Li, Nanchang University, Nanchang, China
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