Association of the time course of Chinese visceral adiposity index accumulation with cardiovascular events in patients with hypertension

Abstract

Background The Chinese visceral adiposity index (CVAI), a simple surrogate measure of visceral fat, is significantly associated with cardiovascular disease (CVD) risk in the general population. This study aimed to evaluate the association of cumulative CVAI (cumCVAI) exposure and its accumulation time course with CVD risk among patients with hypertension. Methods This prospective study involved 15,350 patients with hypertension from the Kailuan Study who were evaluated at least three times in the observation period of 2006 to 2014 (2006–2007, 2010–2011, and 2014–2015) and who were free of myocardial infarction and stroke before 2014. The cumCVAI was calculated as the weighted sum of the mean CVAI for each time interval (value × time). The time course of CVAI accumulation was categorized by splitting the overall accumulation into early (cumCVAI06 − 10) and late (cumCVAI10 − 14) accumulation, or the slope of CVAI versus time from 2006 to 2014 into positive and negative. Results During the 6.59-year follow-up period, 1,184 new-onset CVD events were recorded. After adjusting for confounding variables, the hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD were 1.35 (1.13–1.61) in the highest quartile of cumCVAI, 1.35 (1.14–1.61) in the highest quartile of the time-weighted average CVAI, 1.26 (1.12–1.43) in those with a cumulative burden > 0, and 1.43 (1.14–1.78) for the group with a 10-year exposure duration. When considering the time course of CVAI accumulation, the HR (95% CI) for CVD was 1.33 (1.11–1.59) for early cumCVAI. When considering the combined effect of cumCVAI accumulation and its time course, the HR (95% CI) for CVD was 1.22 (1.03–1.46) for cumCVAI ≥ median with a positive slope. Conclusions In this study, incident CVD risk depended on both long-term high cumCVAI exposure and the duration of high CVAI exposure among patients with hypertension. Early CVAI accumulation resulted in a greater risk increase than later CVAI accumulation, emphasizing the importance of optimal CVAI control in early life.

Chinese visceral adiposity index and its transition patterns: impact on cardiovascular and cerebrovascular diseases in a national cohort study

“…Interestingly, Wang et al [ 47 ] found in the southwestern Chinese population that CVAI serves as a robust predictive indicator for cardiovascular diseases in females, with significant predictive power observed only among female participants, while a gender difference was not evident in our study. Wu et al [ 48 ] concluded from their study on the hypertensive population that prolonged presence in high CVAI and greater duration of exposure to high CVAI could elevate the risk of cardiovascular diseases. Notably, early accumulation of CVAI posed a higher risk compared to later accumulation, which indirectly supported our study findings.…”

Association of adiposity indicators with cardiometabolic multimorbidity risk in hypertensive patients: a large cross-sectional study

“…The China Health and Retirement Longitudinal Study, including 7242 middle-aged and elderly residents, showed that CVAI was associated with a 17% increased risk of incident stroke ( 44 ). Two cohort studies conducted in Xinjiang and Tangshan showed that CVAI was associated with an elevated risk of cardiovascular events in patients with hypertension and type 2 diabetes ( 45 , 47 ). In line with these findings, the present study identified a positive association between CVAI and the risk of CMM in hypertensive patients.…”

The effect of insulin resistance in the association between obesity and hypertension incidence among Chinese middle-aged and older adults: data from China health and retirement longitudinal study (CHARLS)

“…In recent years, there has been increasing evidence that visceral adipose tissue is more closely associated with the onset of hypertension than subcutaneous fat or total fat. Gold standard techniques employed to assess visceral obesity include magnetic resonance imaging (MRI) and computed tomography (CT), however, these methods are not commonly utilized in clinical practice and epidemiological research owing to their inconvenience, high cost and radiation exposure to humans ( 5 ). Xia et al devised the Chinese visceral adiposity index (CVAI) by drawing upon the visceral obesity index (VAI).…”