Background: The literature on the association between the atherogenic index of plasma (AIP) with the risk of major adverse cardiovascular events (MACEs) among non-diabetic hypertensive elderly patients is quite limited at present.
Methods: We performed a post-hoc analysis of data obtained from the Systolic Blood Pressure Intervention Trial (SPRINT) and explored the predictive value of AIP on the risk of MACEs among non-diabetic hypertensive elderly patients, to evaluate whether the benefit of intensive blood pressure control in preventing MACEs is stable in different AIP subgroups.
Results: 9,323 participants with AIP were included in this analysis, and 561(6.02%) participants had composite cardiovascular outcomes during a median of 3.22 years of follow-up. The subjects in the highest quartile of AIP had a significantly increased risk of the primary outcome. In the fully adjusted Model 3, the adjusted HRs of the primary outcome for participants in Q2, Q3, and Q4 of AIP were 1.32 (1.02, 1.72), 1.38 (1.05, 1.81), and 1.56 (1.17, 2.08) respectively. Consistently, the trend test for the association between AIP quartiles and the primary outcome showed that a higher AIP quartile was associated with a significantly higher risk of the primary outcome (adjusted HR (95%CI) in Model 3: 1.14 (1.04, 1.25), P=0,004). However, within each AIP quartile, absolute event rates were lower for the intensive treatment group. No evidence was found for the interaction of intensive blood pressure control and AIP for the risk of the primary outcome (P for interaction = 0.932).
Conclusion: This study found that elevated AIP is independently and positively associated with the risk of MACEs among non-diabetic elderly hypertensive patients. The benefit of intensive blood pressure control in managing cardiovascular events was consistent in different AIP subgroups.