ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
This article is part of the Research TopicCardiovascular Anthropometry For Large Scale Population Studies Volume IIView all 11 articles
Association Between Atherogenic Index of Plasma and Hypertension: Exploring the Mediating Role of Body Mass Index in a Chinese Population Aged ≥ 45 Years
Provisionally accepted
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Background Atherosclerosis is recognized as a potential etiological factor for hypertension[1]. 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 (diabetes vs. non-diabetes groups). Furthermore, mediation analysis was conducted to evaluate the mediating effect of body mass index (BMI) on the AIP and hypertension association. Hypertension was defined as: clinic-measured systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, self-reported physician diagnosis, or current use of antihypertensive medication. 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 hypertensionThis cross-sectional study included 5,254 participants. After multifactorial adjustment, each 1-unit increment in AIP was significantly associated with a 14% increase in hypertension risk (aOR = 1.14, 95% CI: 1.02-1.27)(adjusted odds ratio [aOR] = 1.14, 95% confidence interval [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).
Keywords: Blood Pressure, Hypertension, Atherogenic index of plasma, Triglycerides, diabetes, Mediation analysis
Received: 18 Jul 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Qi, Zhang, Bai, Liu, Liao, Han, Yang, Liu and Wang. 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:
Benling Qi
Lihua Liu
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