The association between lipid accumulation product and the risk of new-onset hypertension in young and middle-aged population: a cohort study

Objective To explore the association between lipid storage index (LAP) and the risk of new-onset hypertension in young and middle-aged people, and to seek new indicators for the prevention and treatment of hypertension in this population.

Methods Using the prospective cohort database of the Kailuan Study, the middle-aged and young population (age ＜ 65 years) who participated in the health check-up of Kailuan Group in 2006 was selected as the research subjects, and a total of 49 738 people were included in the retrospective cohort study. LAP was calculated according to the following formula: for men LAP = waist circumference (cm)−64.72 × triglycerides (mmol/L), for women LAP = waist circumference (cm) − 52.99 × triglycerides (mmol/L). According to the LAP level in 2006 (LAP₂₀₀₆, cm·mmol/L ), the subjects were divided into 4 groups by quartiles: group Q1 (n = 12 443, LAP₂₀₀₆ ＜14.75 ); group Q2 (n =12 429, LAP₂₀₀₆ 14.75 to ＜25.95); group Q3 (n =12 441, LAP₂₀₀₆ 25.95 to ＜45.67); and group Q4 (n=12 435, LAP₂₀₀₆ ≥45.67). According to the quartiles of cumulative LAP (cLAP, unit: cm·mmol/L·year) exposure level, the subjects were divided into 4 groups: group Q1 (n =10 004, cLAP＜68.97); group Q2 (n =10 005, cLAP 68.97 to ＜111.14); group Q3 (n =10 005, cLAP 111.14 to ＜182.48); Q4 group (n =10 005, cLAP≥182.48). The cumulative incidence curves of hypertension were plotted using the Kaplan-Meier method, and the differences between groups were compared using the log-rank test. The Cox proportional hazards regression model was used to analyze the effects of different LAP and cLAP levels on the incidence of new-onset hypertension in the middle-aged and young population.

Results During a median follow-up of 9.6 (4.0, 14.8) years, a total of 16 529 subjects (33.23%) developed new-onset hypertension. The cumulative incidence rates of new-onset hypertension in the first to fourth quartiles of LAP2006 were 24.19%, 33.43%, 40.25%, and 47.39%, respectively. After adjusting for confounding factors, Cox regression analysis showed that compared with the first quartile of LAP2006, the HRs (95%CI) for new-onset hypertension in the second, third, and fourth quartiles were 1.28 (1.22–1.35), 1.52 (1.45–1.60), and 1.66 (1.57–1.76), respectively. Compared with the first quartile of cLAP, the HRs (95%CI) for new-onset hypertension in the second, third, and fourth quartiles were 1.30 (1.21–1.39), 1.57 (1.46–1.68), and 1.86 (1.73–1.98), respectively.

Conclusion The increase in LAP level is associated with an increased risk of new-onset hypertension in young and middle-aged people and is an independent predictor of new-onset hypertension in young and middle-aged people.