The Relationship Between Cardiometabolic Index And Arterial Stiffness In Hypertensive Adults In China

Background:The Cardiometabolic Index（CMI）is an alternative to the traditional obesity index,which has been used to detect a variety of cardiovascular risk factors.However,there are still few studies on the correlation between CMI and arterial stiffness.This study investigated the relationship between CMI and arterial stiffness in rural Chinese adults with hypertension.Methods:Hypertension screening was conducted in Wuyuan,Jiangxi and Yuexi,Anhui,China from March to August 2018,patients information was collected through questionnaires,physical measurements,and laboratory tests.CMI is calculated by multiplying the ratio of waist to height（WHtR）with the ratio of triglyceride and high-density lipoprotein cholesterol（TG/HDL-c）and is considered a new marker of abdominal fat accumulation（visceral obesity）.Additionally,arterial stiffness was assessed using the Brachial-ankle pulse wave conduction velocity（BaPWV）,where increased arterial stiffness is defined as BaPWV≥18m/s.When the measurement data obeyed normal distribution or approximately normal distribution,ANOVA was used for comparison between groups,otherwise,the rank sum test was used,and the chi-square test was used for comparison between groups of count data.Multivariate linear regression and logistic regression analysis was used to determine the relationship between CMI and arterial stiffness,and a subgroup analysis was performed.A smooth fitting curve（penalized spline method）was used to visualize the relationship between CMI and BaPWV and arterial stiffness.Results:A total of 19,048 rural Chinese adults with hypertension were included in this cross-sectional study（mean age:60.0 years;males:47.7 percent）.The median CMI(P₂₅,P₇₅)of the study population baseline was 0.47（0.29,0.80）,the mean±SD of BaPWV was（18.1±4.3）m/s,and 42.1 percent had arterial stiffness.Multivariate linear regression analyses showed that lg CMI was independently and positively associated with ba PWV（adjusted-β,0.36,95%CI 0.30-0.41）.Analyses using restricted cubic spline confirmed that the associations of lg CMI with ba PWV were linear.Logistic regression analyses showed higher lg CMI had the greater risk of increased arterial stiffness（adjusted-OR,1.26,95%CI 1.21-1.31）.When lg CMI was instead treated as a categorical variable divided into quartiles,compared to CMI≤0.29,there was a higher ba PWV value for the participants in the highest quartile of lg CMI（adjusted-β:0.94,95%CI 0.78–1.10）;compared to CMI≤0.29,there was a higher prevalence of increased arterial stiffness for the participants in the highest quartile of lg CMI（adjusted-OR:1.81,95%CI 1.62–2.03）,the trend was statistically significant（P for trend<0.001）.Conclusion:There is a positive correlation between CMI and BAPWV in hypertensive rural Chinese adults,especially in those with SBP≥140 mm Hg.The results suggest that CMI can be applied to clinical practice as a simple and effective method to assess the risk of arterial stiffness.