The Association Between Blood Pressure and Gallstones and the Age of First Cholecystectomy in U.S. Adults: Results from a Cross-Sectional Study

Background To assess the association between hypertension( HTN ) and the prevalence of gallstones and the age at first cholecystectomy in U.S. adults. Methods Data were extracted from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020. Weighted logistic regression analysis, weighted linear regression, weighted subgroup analysis, generalized additive models, smooth fitting curves, and two-piece linear regression models were utilized to evaluate the relationship between HTN, gallstone prevalence, and the age of first cholecystectomy. Results A total of 7,532 participants above 20 years were included in the study. Among them, 817 individuals self-reported a history of cholecystectomy, and 781 individuals self-reported a history of gallstones. After adjusting for age, gender, race, education level, smoking status, marital status,, diabetes, and hypercholesterolemia, HTN was significantly associated with gallstones in individuals aged 48 years and older (OR = 1.39, 95% CI: 1.03, 1.88). Systolic blood pressure was positively related to the age of first cholecystectomy (β = 0.19, 95% CI: 0.12, 0.26), and a nonlinear relationship was observed with a threshold effect at 170 mmHg. Conclusion An association was identified between blood pressure and the prevalence of gallstones in individuals aged 42 years and older. Systolic blood pressure was positively associated with the age of the first cholecystectomy. Although causality cannot be established, these findings may aid in identifying early risk groups for gallstone disease and first cholecystectomy, improving risk stratification, and reducing screening costs.