Association of non-conventional lipid-inflammatory parameters with incident hypertension risk: a prospective cohort study
TL;DR
Non-conventional lipid indices are independently associated with incident hypertension among middle-aged and older Chinese adults and Composite lipid-inflammatory markers provide modest incremental prognostic information beyond conventional lipids, though their standalone discriminatory performance is weak.
Abstract
Background Emerging research has associated non-conventional lipid indices with hypertension risk; however, the joint contribution of these lipid metrics and inflammatory biomarkers to hypertension susceptibility remains unclear. Using a nationally representative cohort, we aimed to examine the independent associations of non-conventional lipid indices and their inflammatory composites with incident hypertension. Methods We included 6891 participants from the China Health and Retirement Longitudinal Study (2011–2020). We used multivariable Cox proportional hazards regression to assess the association between baseline and cumulative non-conventional lipid-inflammatory parameters and incident hypertension. We used restricted cubic spline modelling to characterise dose-response relationships. We evaluated receiver operating characteristic curves, net reclassification improvement, and integrated discrimination improvement as secondary conditional analyses. Results Over a median follow-up of 7.79 years, 2532 incident hypertension cases occurred. Higher tertiles of non-conventional lipid indices were associated with progressively increased hypertension risk. In the primary model, elevated baseline and cumulative non-conventional lipid metrics were associated with a higher risk of hypertension across all composite indices. The lipoprotein combine index-C-reactive protein showed the largest effect size (hazard ratio = 1.59; 95% confidence interval = 1.44–1.75). Composite indices demonstrated modest incremental discrimination over individual measures (area under the curve range = 0.55–0.58). Conclusions Non-conventional lipid indices are independently associated with incident hypertension among middle-aged and older Chinese adults. Composite lipid-inflammatory markers provide modest incremental prognostic information beyond conventional lipids, though their standalone discriminatory performance is weak.