Visceral Adiposity and Inflammation Index as Predictors of Stroke Risk in Middle and Older Age: A Cohort Study Across Blood Pressure Groups.

During a median follow-up of 9 years, 9.31% of participants developed stroke.

• Data from 8883 participants in the China Health and Retirement Longitudinal Study were analyzed.
• 827 participants (9.31%) developed stroke during the follow-up period.
• Median follow-up duration was 9 years.
• VAII levels were categorized into quartiles and stroke incidence was assessed across these groups.

A 1-SD increase in VAII was independently associated with higher stroke risk in fully adjusted models.

• HR = 1.048 (95% CI: 1.009–1.089) per 1-SD increase in VAII.
• This association was observed in fully adjusted models.
• Sensitivity analyses including complete-case analysis, multiple imputation, and E-value calculation supported the robustness of the findings.

Participants in the highest VAII quartile had more than twice the stroke risk compared to those in the lowest quartile.

• Q4 vs. Q1: HR = 2.138 (95% CI: 1.720–2.658).
• Stroke incidence increased progressively across VAII quartiles.
• Restricted cubic spline analysis indicated a nonlinear relationship between VAII and stroke risk.

The association between VAII and stroke risk was present in elevated BP and hypertension groups but not in the normal BP group.

• In the elevated BP group, Q4 vs. Q1: HR = 2.034.
• In the hypertension group, Q3: HR = 1.906 and Q4: HR = 1.713.
• No significant association was observed in the normal BP group.
• The association between VAII and stroke was nonlinear in individuals with elevated BP and hypertension.

The association between VAII and stroke risk was stronger in women and in middle-aged adults (40–60 years) compared to other subgroups.

• Stronger associations were observed in women compared to men.
• Adults aged 40–60 years showed stronger associations than older adults.
• A nonlinear relationship was observed between VAII and stroke risk in both males and females, as well as in middle-aged and older adults.
• Subgroup analyses were stratified by sex and age group.

VAII is a composite index combining the visceral adiposity index (VAI) and high-sensitivity C-reactive protein (hs-CRP), both of which are individually associated with stroke risk.

• The visceral adiposity and inflammation index (VAII) integrates VAI and hs-CRP.
• Both VAI and hs-CRP are established components linked to stroke risk.
• The study aimed to investigate whether this composite measure improves prediction of stroke risk across different BP statuses, sexes, and age groups.