Delian Zhang,1– 5,* Kangxin Cai,1– 5,* Qing Zhu,1– 5 Aliye Abulaiti,1– 5 Jing Hong,1– 5 Yingchun Wang,1– 5 Nanfang Li1– 5 

1Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People’s Republic of China; 2Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People’s Republic of China; 3NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People’s Republic of China; 4Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang, People’s Republic of China; 5Hypertension Research Laboratory, Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Nanfang Li, Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Urumqi, Xinjiang, 830001, People’s Republic of China, Tel +86 8564818, Email lnanfang2016@sina.com

Objective: Previous studies have mainly focused on the relationship between the Chinese Visceral Adiposity Index (CVAI) and obstructive sleep apnea (OSA) in general or overweight/obese populations. However, normal-weight hypertensive patients represent a clinically relevant yet understudied group, in whom OSA risk may be underestimated due to the absence of overt obesity. This study aimed to investigate the association between CVAI and OSA in normal-weight patients with hypertension, given the important role of visceral adiposity in the pathogenesis of OSA.
Materials and Methods: In this cross-sectional study, hypertensive patients admitted between January 1, 2021, and December 31, 2023, were enrolled. Multivariate logistic and linear regression analyses were conducted. Additionally, restricted cubic spline (RCS) analyses were used to examine potential dose–response relationships.
Results: A total of 6659 hypertensive patients were included. After adjusting for potential confounders, elevated CVAI levels were significantly associated with an increased risk and severity of OSA. RCS analyses demonstrated a clear linear dose–response relationship between CVAI and both the presence of OSA and apnea–hypopnea index (AHI) levels. These results were robust across both subgroup and sensitivity analyses.
Conclusion: Our study results indicate that CVAI is associated with the occurrence and severity of OSA in hypertensive patients with normal body weight. Further research is needed to confirm these findings.

Keywords: Chinese visceral adiposity index, obstructive sleep apnoea, apnoea-hypopnea index, cross-sectional study