Correlation between Lipid Accumulation Product and the Incidence of Hypertension in Adults: a Prospective Cohort Study

Background Hypertension is a common disease among residents, characterized by insidious onset, high incidence, high disability rate, low control rate, and low awareness rate, posing a significant threat to residents' health. In recent years, medical research has discovered a certain association between the lipid accumulation index (LAP) and hypertension. However, current cohort studies on the risk of hypertension incidence related to adult LAP are still limited. This research aims to explore the association between adult LAP and the incidence of hypertension through long-term follow-up observation, providing reliable scientific evidence for the prevention and control of hypertension in the population. Objective To investigate the relationship between lipid accumulation index in adults and the incidence of hypertension. Methods A baseline survey was conducted in 2010 among 9 280 individuals from 48 townships in 12 counties (districts) in Guizhou Province. Baseline information, physical examination results, and laboratory test results were collected from the participants. Follow-up surveys were conducted in 2016 and 2020. Multivariable Cox proportional hazards regression analysis was used to assess the correlation between LAP and the incidence of hypertension in the population. The Schoenfeld residual method was employed to test the proportional hazards assumption. Results Ultimately, 3 774 individuals were included in this study, with 806 new cases of hypertension (21.36%) and 2 968 individuals without hypertension (78.64%). Statistically significant differences were observed between the two groups in terms of LAP, LAP distribution, gender, age, residence, occupation type, current smoking, harmful alcohol consumption, excessive oil intake, waist circumference, and triglyceride (TG) levels (P<0.05). Participants were divided into four groups based on LAP quartiles: Q1 (198 cases), Q2 (238 cases), Q3 (297 cases), and Q4 (394 cases). Multivariable Cox proportional hazards regression analysis revealed that the risk of hypertension in the Q4 group was 1.43 times that of the Q1 group (P<0.05). A non-linear dose-response relationship was observed between LAP levels and the risk of hypertension in the overall population (Pnon-linear=0.004). Subgroup analyses showed that, among males, the risk of hypertension increased in the Q3 (HR=1.67, 95%CI=1.24-2.25) and Q4 (HR=1.62, 95%CI=1.20-2.16) groups compared to the Q1 group (P<0.05). In the 18-45 and 46-60 age groups, the risk of hypertension increased in the Q4 group compared to the Q1 group (HR=1.58, 95%CI=1.20-2.09, P<0.001; HR=1.51, 95%CI=1.07-2.11, P=0.018). Among individuals primarily engaged in physical labor, the risk of hypertension increased in the Q4 group compared to the Q1 group (HR=1.28, 95%CI=1.02-1.59, P=0.030). Among individuals primarily engaged in mental labor, the risk of hypertension gradually increased with elevated LAP levels compared to the Q1 group (P<0.05) . Conclusion As a simple indicator for assessing abdominal obesity, LAP has a certain predictive effect on the risk of hypertension. Its predictive efficacy varies among different populations, with better performance in males and middle-aged and young adults. LAP can serve as a screening indicator for classifying individuals at risk of hypertension in primary healthcare or medical examination settings during health management services.