Hyperlipidemia and hypertension have synergistic interaction on ischemic stroke: insights from a general population survey in China

BMC Cardiovascular Disorders

Chuning Shi¹  Chang Wang¹  Ning Ye¹  Songyue Liu¹  Yingxian Sun¹  Danxi Geng¹  Zhi Du² 

[1] Department of Cardiovascular Medicine, The First Hospital of China Medical University, 110001, ShenyangLiaoning, China;The First Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, Zhejiang, China;

关键词: Hypertension;    Hyperlipidemia;    Ischemic stroke;    Synergistic interaction;    Epidemiology;   

DOI  :  10.1186/s12872-022-02491-2

来源: Springer

【 摘 要 】

BackgroundHyperlipidemia (HLP) and hypertension (HTN) are both independent risk factors for ischemic stroke. This study aimed to assess whether HTN and HLP have a synergistic effect on the risk of ischemic stroke.MethodsBetween January and August 2013, 11,695 subjects in rural areas of northeastern China were enrolled. The additive and multiplicative scales were used to evaluate the interaction.ResultsThe prevalence of ischemic stroke was 5.7%. Using the healthy group (without HTN or HLP) as the reference group, subjects with both HTN and HLP had a higher risk of ischemic stroke (odds ratio [OR]: 3.369, 95% confidence interval [CI]: 2.579–4.402), and this OR was greater than that of subjects with only HTN (OR: 1.995, 95% CI 1.526–2.610) or HLP (OR: 1.321, 95% CI 0.937–1.862) (adjusting for age, sex, race, education level, family income, current smoking and drinking status, physical activity, body mass index, diabetes, family history of stroke, and atrial fibrillation). Regarding the additive scale, the relative excess risk due to interaction (OR: 1.053, 95% CI 0.458–1.648) was positive after adjusting for confounders. Moreover, the attributable proportion was 31.3%, which means that 31.3% of the total risk of ischemic stroke was due to the synergistic interaction between HTN and HLP. Furthermore, the synergistic index (S) of ischemic stroke was 1.8 (95% CI 1.157–2.801), which also indicates a synergistic interaction between HTN and HLP. Regarding the multiplicative scale, the interaction effect was also significant after adjusting for confounders (OR: 2.163, 95% CI 1.817–2.575).ConclusionThe results suggest that the synergistic effect of HTN and HLP on ischemic stroke is significantly higher than the sum of their independent effects. The quantification of the combined effect should help to promote healthy blood pressure and blood lipid levels among the general population.

【 授权许可】

CC BY