The effect of lipid accumulation product and its interaction with other factors on hypertension risk in Chinese Han population: A cross-sectional study

OBJECTIVES: Lipid accumulation product (LAP) is a simple and effective indicator that reflects visceral obesity. This study aimed to compare the significance of LAP in predicting hypertension risk with other obesity indices, and to evaluate the interactive effects of LAP and smoking, family history of hypertension on hypertension risk in Chinese Han adults. METHODS: A community based cross-sectional study was performed in Bengbu, China. Participants received face-to-face questionnaire survey, anthropometric tests and laboratory examinations. Relevant indicators that reflect obesity including BMI (body mass index), waist-to-height ratio (WHtR) and LAP were calculated. Multivariate logistic regression analysis was applied to explore the association between LAP and hypertension risk. The area under the receiver-operating characteristics curves (AUC) of LAP, BMI, and WHtR were calculated and then compared. Interactive effect was evaluated by relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS: A total of 1777 participants were enrolled, and the prevalence of hypertension was 24.4% (n = 433). There was a significant increase in hypertension risk with LAP levels in the fourth quartile as compared with the bottom quartile (OR: 3.31, 95%CI: 1.76–6.25). The AUC of LAP was significantly different than that of BMI in males (Z = 2.158, p = 0.0309) and females (Z = 3.570, p = 0.0004), while only performed better in females as compared with that of WHtR (Z = 2.166, p = 0.0303). LAP was significantly interacted with family history of hypertension on hypertension risk both in males (RERI: 1.07, 95%CI: 0.09–2.05; AP: 0.33, 95%CI: 0.23–0.44; SI: 1.92, 95%CI: 1.53–2.41) and females (RERI: 0.80, 95%CI: 0.07–1.53; AP: 0.25, 95%CI: 0.11–0.39; SI: 1.59, 95%CI: 1.16–2.19). However, a significant interaction between LAP and smoking was only observed in males (RERI: 1.32, 95%CI: 0.15–2.75; AP: 0.40, 95% CI: 0.14–0.73). CONCLUSION: Increased LAP was significantly associated with a higher risk of hypertension in Chinese Han adults. Moreover, the effect of LAP on predicting hypertension risk was better than that of other obesity indices. Our results also demonstrated interactive effects of LAP with smoking, family history of hypertension on hypertension risk.