Key result
Cardiometabolic indices like CVAI are linked to ~117% greater odds of abnormal blood pressure per SD.
Why the study?
Prehypertension and hypertension are cardiovascular risk states, prompting an evaluation of whether biomarker-derived atherogenic, cardiometabolic, and adiposity indices are associated with blood pressure status in adults undergoing health examinations.
Are biomarker-derived atherogenic, cardiometabolic, and adiposity composite indices associated with prehypertension and hypertension in adults?
Cross-Sectional (n=2,136)
No
Are biomarker-derived atherogenic, cardiometabolic, and adiposity composite indices associated with prehypertension and hypertension in adults?
Composite indices integrating visceral adiposity, insulin resistance, and lipid burden are strongly associated with prehypertension and hypertension, and can improve screening performance when added to clinical models.
Answers are grounded in this paper and cite their sources.
CVAI was associated with abnormal BP; hypothesis-generating for visceral adiposity indices in risk assessment, needs prospective validation.
Background Prehypertension and hypertension are cardiovascular risk states. We examined whether biomarker-derived atherogenic, cardiometabolic, and adiposity indices were associated with blood pressure status in adults undergoing health examinations. Methods This hospital-based cross-sectional study included 2, 136 adults from the Health Examination Center of the Second Affiliated Hospital of Shandong First Medical University between 2024 and 2025. Blood pressure was classified as normal, prehypertension, or hypertension. Composite indices were reconstructed from anthropometric, biochemical, and questionnaire variables. Analyses included multivariable regression, quartiles, 3-knot restricted cubic splines, mixture analysis, incremental evaluation, explainable machine learning, subgroup analyses, and sensitivity analyses. Results The cohort included 983 participants with normal blood pressure (46.02%), 422 with prehypertension (19.76%), and 731 with hypertension (34.22%). In fully adjusted analyses, CVAI (OR, 2.17 (1.80-2.62); P<0.01), TyG-WC (OR, 1.94 (1.64-2.28); P<0.01), TyG-BMI (OR, 1.93 (1.66-2.26); P<0.01), and METS-IR (OR, 1.91 (1.63-2.24); P<0.01) showed the strongest standardized associations with abnormal blood pressure. The highest quartiles of CVAI, METS-IR, and TyG-WHtR had higher odds than the lowest quartiles (all P for trend <0.01). Cross-validated AUROC improved from 0.80 to 0.83 after adding clinical and index information. SHAP highlighted CVAI, age, fasting glucose, waist circumference, eGFR, and uric acid. Conclusions Composite indices integrating visceral adiposity, insulin resistance, and lipid burden were associated with prehypertension and hypertension. They may help characterize cardiometabolic risk clustering but are not substitutes for direct blood pressure measurement or diagnostic evaluation. These findings support association and screening-value inference, not causal or diagnostic claims.
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Sun et al. (2026) conducted a cross-sectional in Prehypertension and hypertension (n=2,136). Composite cardiometabolic indices (e.g., CVAI) vs. Lower index values (per 1-SD increment) was evaluated on Abnormal blood pressure (prehypertension or hypertension) (OR 2.17, 95% CI 1.80-2.62, p=<0.01). Composite indices integrating visceral adiposity, insulin resistance, and lipid burden, particularly CVAI (OR 2.17 per 1-SD increment), were strongly associated with abnormal blood pressure.
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