Association between cardiometabolic index and hypertension among US adults from NHANES 1999–2020

Abstract Hypertension, a major global health issue and leading cause of death, is often under-assessed by traditional metrics like Body Mass Index which fail to capture comprehensive cardiovascular risks associated with obesity. The Cardiometabolic Index (CMI), which evaluates abdominal obesity and...

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Main Authors: Tuo Guo, Yang Zhou, Guifang Yang, Lijuan Sheng, Xiangping Chai
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-87029-0
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author Tuo Guo
Yang Zhou
Guifang Yang
Lijuan Sheng
Xiangping Chai
author_facet Tuo Guo
Yang Zhou
Guifang Yang
Lijuan Sheng
Xiangping Chai
author_sort Tuo Guo
collection DOAJ
description Abstract Hypertension, a major global health issue and leading cause of death, is often under-assessed by traditional metrics like Body Mass Index which fail to capture comprehensive cardiovascular risks associated with obesity. The Cardiometabolic Index (CMI), which evaluates abdominal obesity and dyslipidemia, offers a more accurate assessment of visceral fat and metabolic dysfunction. In this study, we analyzed data from 45,250 participants from the National Health and Nutrition Examination Survey spanning 1999 to 2020. Using multivariable logistic regression, we explored the association between CMI and hypertension, employing Restricted Cubic Spline analysis to assess non-linear relationships and two-piecewise linear regression to identify threshold effects. Subgroup analyses confirmed the consistency of our findings across various demographic and clinical characteristics. Findings confirmed that hypertensive participants exhibited significantly higher CMI levels (median 0.46 vs. 0.73), with adjusted logistic regression showing a notable association between increased CMI and hypertension prevalence (OR 1.30, 95% CI 1.25–1.35, P < 0.01), characterized by a nonlinear L-shaped curve with a critical threshold identified at a CMI value of 1.37. Subgroup analysis revealed a more pronounced impact of CMI on hypertension in females. These results underscore CMI’s potential to enhance cardiovascular risk assessment across diverse U.S. populations.
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spelling doaj-art-4061cb23bec84c838f3b0850254dd9782025-02-02T12:22:44ZengNature PortfolioScientific Reports2045-23222025-02-0115111110.1038/s41598-025-87029-0Association between cardiometabolic index and hypertension among US adults from NHANES 1999–2020Tuo Guo0Yang Zhou1Guifang Yang2Lijuan Sheng3Xiangping Chai4Department of Emergency Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Intensive Care Unit, The Second Xiangya Hospital, Central South UniversityDepartment of Emergency Medicine, The Second Xiangya Hospital, Central South UniversityClinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South UniversityDepartment of Emergency Medicine, The Second Xiangya Hospital, Central South UniversityAbstract Hypertension, a major global health issue and leading cause of death, is often under-assessed by traditional metrics like Body Mass Index which fail to capture comprehensive cardiovascular risks associated with obesity. The Cardiometabolic Index (CMI), which evaluates abdominal obesity and dyslipidemia, offers a more accurate assessment of visceral fat and metabolic dysfunction. In this study, we analyzed data from 45,250 participants from the National Health and Nutrition Examination Survey spanning 1999 to 2020. Using multivariable logistic regression, we explored the association between CMI and hypertension, employing Restricted Cubic Spline analysis to assess non-linear relationships and two-piecewise linear regression to identify threshold effects. Subgroup analyses confirmed the consistency of our findings across various demographic and clinical characteristics. Findings confirmed that hypertensive participants exhibited significantly higher CMI levels (median 0.46 vs. 0.73), with adjusted logistic regression showing a notable association between increased CMI and hypertension prevalence (OR 1.30, 95% CI 1.25–1.35, P < 0.01), characterized by a nonlinear L-shaped curve with a critical threshold identified at a CMI value of 1.37. Subgroup analysis revealed a more pronounced impact of CMI on hypertension in females. These results underscore CMI’s potential to enhance cardiovascular risk assessment across diverse U.S. populations.https://doi.org/10.1038/s41598-025-87029-0Cardiometabolic indexHypertensionNHANESVisceral adiposityMetabolic dysfunction
spellingShingle Tuo Guo
Yang Zhou
Guifang Yang
Lijuan Sheng
Xiangping Chai
Association between cardiometabolic index and hypertension among US adults from NHANES 1999–2020
Scientific Reports
Cardiometabolic index
Hypertension
NHANES
Visceral adiposity
Metabolic dysfunction
title Association between cardiometabolic index and hypertension among US adults from NHANES 1999–2020
title_full Association between cardiometabolic index and hypertension among US adults from NHANES 1999–2020
title_fullStr Association between cardiometabolic index and hypertension among US adults from NHANES 1999–2020
title_full_unstemmed Association between cardiometabolic index and hypertension among US adults from NHANES 1999–2020
title_short Association between cardiometabolic index and hypertension among US adults from NHANES 1999–2020
title_sort association between cardiometabolic index and hypertension among us adults from nhanes 1999 2020
topic Cardiometabolic index
Hypertension
NHANES
Visceral adiposity
Metabolic dysfunction
url https://doi.org/10.1038/s41598-025-87029-0
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