Association and interaction of blood pressure, HbA1c and lipid profiles with carotid artery plaque in a general health check-up population: a cross-sectional study

Carotid artery plaque (CAP) is a significant predictor of cardiovascular disease (CVD), yet the specific thresholds of blood pressure (BP), HbA1c, and lipid profiles associated with CAP remain unclear in general populations. This study aimed to investigate the association and interaction between BP, HbA1c, and lipid profiles with CAP in a general health check-up population. This cross-sectional study analyzed 1,616 adults from a health check-up cohort. Binary logistic regression was used to analyze the associations between blood pressure levels, HbA1c categories, lipid profiles and CAP, followed by further analysis on the relationship between the number of coexisting risk factors and CAP. CAP prevalence was 39.8%. In multi-adjusted logistic models, the ORs (95% CIs) of CAP were 1.85 (1.23–2.79) for hypertension stage 1 (130mmHg ≤ SBP<140mmHg or 80mmHg ≤ DBP<90mmHg) and 2.30 (1.54–3.43) for stage 2 (SBP≥140mmHg or DBP≥90mmHg) compared to those with normal BP; the ORs (95% CIs) of CAP were 1.49 (1.08–2.06) for slightly elevated HbA1c (5.7–6.4%) and 2.34 (1.43–3.83) for elevated HbA1c (≥ 6.5%) compared to those with normal HbA1c; the OR (95% CI) of CAP were 1.79 (1.21–2.65) for elevated LDL-C compared to those with reasonable level LDL-C. A dose-dependent relationships between the number of high-risk factors and higher prevalence of CAP was observed (adjusted OR for 3 factors = 4.94, 95% CI: 2.50–9.76). Hypertension stage 1, slightly elevated HbA1c and elevated LDL-C were independently associated with CAP in the general population, exhibiting cumulative effects. Even below traditional diagnostic thresholds, these factors carried clinical relevance.