[Interaction of obesity and dyslipidemia on the risk of hypertension]

Objective: To understand the interaction effect of general obesity, central obesity, and dyslipidemia on the risk of hypertension to provide scientific evidence for the early prevention and control of hypertension. Methods: From 2019 to 2023, 10 of the 16 districts in Tianjin were selected as project sites. A community and a natural village were selected as monitoring sites in each project site using a multi-stage cluster random sampling method. A questionnaire, physical, and biochemical examination were conducted on permanent residents aged 35-75 who had lived in the surveillance sites for more than half a year. The chi-square test univariate and multivariate logistic regression were used for statistical analysis. The multiplicative and additive models were used to calculate the interaction between general obesity and dyslipidemia, as well as central obesity and dyslipidemia, respectively. Results: A total of 177 160 subjects were included in the study, with an age of (56.44±8.62) years old. There were 29 535 (16.67%) patients with general obesity, 67 338 (38.01%) patients with central obesity, 64 906 (36.64%) patients with dyslipidemia, and 90 266 (50.95%) patients with hypertension. Multiplication interaction analysis results showed that, after adjusting for gender, age, culture level, marriage status, drinking, smoking, and diabetes, the multiplicative interactions between general obesity and dyslipidemia, and central obesity and dyslipidemia on hypertension were statistically significant (all P<0.001), and the adjusted OR and 95%CI were 2.57 (2.47-2.68) and 2.14 (2.08-2.20), respectively. The results of the additive interaction analysis demonstrated that after adjusting for relevant variables, the relative excess risk of interaction (RERI), the attributable proportion of interaction (API), and the synergy index (SI) of the interaction between generalized obesity and dyslipidemia were 0.48 (95%CI: 0.33-0.63), 0.15 (95%CI: 0.11-0.19), and 1.27 (95%CI: 1.18-1.36), respectively; the RERI, API, and SI of the interaction between central obesity and dyslipidemia were 0.37 (95%CI: 0.28-0.46), 0.13 (95%CI: 0.10-0.16), and 1.25 (95%CI: 1.18-1.32), respectively. Conclusions: There might be multiplicative and additive interactions between general obesity, central obesity, and dyslipidemia on the risk of hypertension. Simultaneous control of BMI, waist circumference, and blood lipid levels may effectively reduce the risk of hypertension.