# Body Mass Index as a Potential Mediator of the Association Between Gout and Hypertension Among Chinese Older Adults: A Mediation Analysis in a Cross‐Sectional Study

## TL;DR

This study shows that body mass index partly explains the link between gout and high blood pressure in older Chinese adults.

## Contribution

The study identifies BMI as a significant mediator in the gout-hypertension relationship using mediation analysis.

## Key findings

- BMI mediates 12.59% of the total effect between gout and hypertension.
- Gout is directly and indirectly linked to hypertension through BMI-related pathways.
- Controlling BMI in elderly gout patients may help manage hypertension progression.

## Abstract

This study aimed to investigate the role of the body mass index (BMI) as a mediator between gout and hypertension in older adults.

A total of 33,778 older adults (aged 65 years and over) in Wuhan, China, were surveyed. The propensity score matching (PSM) method was used to control for confounding factors, and logistic regression was performed on the above three variables using the mediation package in the R language program.

The PSM method successfully matched 14,717 pairs. Mediation analysis revealed that, when controlling for the mediating variable “BMI”, the association coefficients of the independent variable “gout” on the dependent variable “hypertension” and of the mediating variable were statistically significant. This indicates the existence of a mediating association. Bootstrapping was used to quantify the stability of the observed indirect association, but temporal precedence or causality could not be established in this cross‐sectional study.

Gout is associated with hypertension, both directly and indirectly through BMI‐related pathways. Therefore, monitoring and controlling the BMI of elderly gout patients to improve the progression of hypertension is of great significance.

This study employed mediation analysis and found that BMI played a significant mediating role in the relationship between gout and hypertension. The mediating effect accounted for 12.59% of the total effect (ACME = 0.0244). ACME, average causal mediation effect.