Associations between the atherogenic index of plasma and coronary heart disease in hypertensive patients: results from NHANES 2005–2018

BACKGROUND: Although the association between atherosclerotic burden and coronary heart disease (CHD) is well established, its specific mechanistic role and risk contribution in hypertensive patients require further investigation. Therefore, this study employed the atherogenic index of plasma (AIP) to quantify atherosclerotic burden and systematically analyze its relationship with CHD in this population. METHODS: The National Health and Nutrition Examination Survey (NHANES) 2005-2018 cycle data included data from 6,290 people with verified hypertension. To investigate the relationship between AIP and CHD in hypertensive patients, we used weighted logistic regression, smoothed curve fitting, interaction tests, subgroup analyses, and receiver operating characteristic (ROC) curve analysis. RESULTS: There was a significant association between the AIP and CHD in hypertensive patients for every unit increase in the AIP (OR = 1.58, 95% CI: 1.25-2.01, p < 0.0001) in the fully adjusted model. Additionally, the highest AIP quartile group (Q4) had 43% greater odds of CHD incidence (OR = 1.43, 95% CI: 1.15-1.79, p = 0.0008) than did the Q1 group. The trend was consistent across all population subgroups. ROC analysis revealed that the AIP had the best predictive effect, with an area under the curve (AUC) of 0.695. CONCLUSIONS: In hypertensive patients, there is a significant positive correlation between the incidence of CHD and elevated AIP levels, and the AIP has better predictive performance.