Relationship Between Atherogenic Index of Plasma and Hypertension in Chinese Middle‐Aged and Older Adults: A Cross‐Sectional and Longitudinal Analysis Based on CHARLS

Objectives Atherosclerosis is the underlying pathology of cardiovascular disease (CVD), including hypertension. Unfortunately, the association between the atherogenic index of plasma (AIP) and hypertension has not been reported in a large‐scale middle‐aged and elderly population. This study aimed to evaluate the association between AIP and hypertension in a representative middle‐aged and elderly population in China. Methods The present study was a retrospective cohort study. We conducted cross‐sectional and longitudinal analysis using data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. Hypertension was identified by self‐report or by taking antihypertensive medications. Participants aged below 45 years, with missing data on AIP, hypertension records, or taking lipid‐lowering medication were excluded. Results A total of 12,376 participants were included in the cross‐sectional analysis; we found that after adjusting for covariates, each unit increment in AIP was associated with a 109.0% increased prevalence of hypertension (OR = 2.090, 95% CI: 1.776–2.459), a 41.2% increased likelihood of systolic blood pressure (SBP) above 140 mmHg (OR = 1.412, 95% CI: 1.199–1.664), and a 43.9% increased likelihood of diastolic blood pressure (DBP) above 90 mmHg (OR = 1.439, 95% CI: 1.153–1.795). A total of 5649 participants were included in the longitudinal analysis; we found that every one‐unit increase in AIP was associated with a 57.7% increase in hypertension incidence (OR = 1.577, 95% CI: 1.282–1.941, p < 0.001) during 7 years follow‐up. Conclusions These results demonstrated a significant positive association between AIP and the prevalence and incidence of hypertension in a nationwide representative middle‐aged and elderly population in China.