Prognostic nutritional index as a predictor of cardiovascular and all-cause mortality in American adults with hypertension: results from the NHANES database
BackgroundFew studies have examined the relationship between nutritional status, as assessed by the Prognostic Nutrition Index (PNI), and incident cardiovascular mortality and all-cause mortality, particularly in hypertensive patients. This study aimed to examine the association between PNI and card...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1465379/full |
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| author | Jing Tang Jing Tang Long Yang Guan-Ying Yang Yan-Hong Li You-Sen Zhu Hui Li Xiao-Ming Gao Xiao-Ming Gao Xiao-Ming Gao |
| author_facet | Jing Tang Jing Tang Long Yang Guan-Ying Yang Yan-Hong Li You-Sen Zhu Hui Li Xiao-Ming Gao Xiao-Ming Gao Xiao-Ming Gao |
| author_sort | Jing Tang |
| collection | DOAJ |
| description | BackgroundFew studies have examined the relationship between nutritional status, as assessed by the Prognostic Nutrition Index (PNI), and incident cardiovascular mortality and all-cause mortality, particularly in hypertensive patients. This study aimed to examine the association between PNI and cardiovascular mortality and all-cause mortality in Americans with hypertension.MethodsData from this retrospective cohort study were obtained from the National Health and Nutrition Examination (NHANES) 1999–2016. Using data of The NHANES Public-Use Linked Mortality Files to assess all-cause mortality (ACM) and cardiovascular mortality (CVM). After excluding participants younger than 18 years, without hypertension, and with missing follow-up data, a total of 18,189 cases were included in this study. Persons with hypertension were divided by PNI into 4 groups: Q1 (PNI < 49.0), Q2 (PNI: 49.0–52.5), Q3 (PNI: 52.5–55.5), and Q4 (PNI > 55.5). We used the Cox proportional hazard regression model to explore the predictive role of PNI on ACM and CVM in American adults with hypertension. Restricted cubic spline (RCS) curves to investigate the existence of a dose-response linear relationship between them.ResultDuring a median follow-up period of 89 months, a total of 1,444 (7.94%) cardiovascular deaths occurred and 5,171 (28.43%) all-cause deaths occurred. Multifactorial COX regression analysis showed all-cause mortality [hazard ratio (HR): 0.584, 95% CI: 0.523–0.652, p < 0.001] and cardiovascular mortality (HR: 0.435, 95% CI: 0.349–0.541, p < 0.001) associated with Q4 group risk of malnutrition in PNI compared to Q1 group. RCS curves showed a nonlinear relationship between PNI and all-cause mortality and cardiovascular mortality (both non-linear p < 0.001).ConclusionsLower PNI levels are associated with mortality in patients with hypertension. PNI may be a predictor of all-cause mortality and cardiovascular mortality risk in patients with hypertension. |
| format | Article |
| id | doaj-art-92b0db10f2e44746a1bf1a3bd7d5c12c |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-92b0db10f2e44746a1bf1a3bd7d5c12c2025-01-06T06:59:40ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.14653791465379Prognostic nutritional index as a predictor of cardiovascular and all-cause mortality in American adults with hypertension: results from the NHANES databaseJing Tang0Jing Tang1Long Yang2Guan-Ying Yang3Yan-Hong Li4You-Sen Zhu5Hui Li6Xiao-Ming Gao7Xiao-Ming Gao8Xiao-Ming Gao9State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaClinical Laboratory, First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaPediatric Cardiothoracic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaPharmacy Department, Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaClinical Laboratory, First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaClinical Laboratory, First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaClinical Laboratory, First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaState Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaXinjiang Key Laboratory of Medical Animal Model Research, Xinjiang Medical University, Urumqi, ChinaClinical Medical Research Institute, Xinjiang Medical University, Urumqi, ChinaBackgroundFew studies have examined the relationship between nutritional status, as assessed by the Prognostic Nutrition Index (PNI), and incident cardiovascular mortality and all-cause mortality, particularly in hypertensive patients. This study aimed to examine the association between PNI and cardiovascular mortality and all-cause mortality in Americans with hypertension.MethodsData from this retrospective cohort study were obtained from the National Health and Nutrition Examination (NHANES) 1999–2016. Using data of The NHANES Public-Use Linked Mortality Files to assess all-cause mortality (ACM) and cardiovascular mortality (CVM). After excluding participants younger than 18 years, without hypertension, and with missing follow-up data, a total of 18,189 cases were included in this study. Persons with hypertension were divided by PNI into 4 groups: Q1 (PNI < 49.0), Q2 (PNI: 49.0–52.5), Q3 (PNI: 52.5–55.5), and Q4 (PNI > 55.5). We used the Cox proportional hazard regression model to explore the predictive role of PNI on ACM and CVM in American adults with hypertension. Restricted cubic spline (RCS) curves to investigate the existence of a dose-response linear relationship between them.ResultDuring a median follow-up period of 89 months, a total of 1,444 (7.94%) cardiovascular deaths occurred and 5,171 (28.43%) all-cause deaths occurred. Multifactorial COX regression analysis showed all-cause mortality [hazard ratio (HR): 0.584, 95% CI: 0.523–0.652, p < 0.001] and cardiovascular mortality (HR: 0.435, 95% CI: 0.349–0.541, p < 0.001) associated with Q4 group risk of malnutrition in PNI compared to Q1 group. RCS curves showed a nonlinear relationship between PNI and all-cause mortality and cardiovascular mortality (both non-linear p < 0.001).ConclusionsLower PNI levels are associated with mortality in patients with hypertension. PNI may be a predictor of all-cause mortality and cardiovascular mortality risk in patients with hypertension.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1465379/fullprognostic nutritional indexhypertensionall-cause mortalitycardiovascular mortalitycohort study |
| spellingShingle | Jing Tang Jing Tang Long Yang Guan-Ying Yang Yan-Hong Li You-Sen Zhu Hui Li Xiao-Ming Gao Xiao-Ming Gao Xiao-Ming Gao Prognostic nutritional index as a predictor of cardiovascular and all-cause mortality in American adults with hypertension: results from the NHANES database Frontiers in Cardiovascular Medicine prognostic nutritional index hypertension all-cause mortality cardiovascular mortality cohort study |
| title | Prognostic nutritional index as a predictor of cardiovascular and all-cause mortality in American adults with hypertension: results from the NHANES database |
| title_full | Prognostic nutritional index as a predictor of cardiovascular and all-cause mortality in American adults with hypertension: results from the NHANES database |
| title_fullStr | Prognostic nutritional index as a predictor of cardiovascular and all-cause mortality in American adults with hypertension: results from the NHANES database |
| title_full_unstemmed | Prognostic nutritional index as a predictor of cardiovascular and all-cause mortality in American adults with hypertension: results from the NHANES database |
| title_short | Prognostic nutritional index as a predictor of cardiovascular and all-cause mortality in American adults with hypertension: results from the NHANES database |
| title_sort | prognostic nutritional index as a predictor of cardiovascular and all cause mortality in american adults with hypertension results from the nhanes database |
| topic | prognostic nutritional index hypertension all-cause mortality cardiovascular mortality cohort study |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1465379/full |
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