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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Hypertension
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1465379

Prognostic Nutritional Index (PNI) as a Predictor of Cardiovascular and All-Cause Mortality in American Adults with Hypertension: results from the NHANES database

Provisionally accepted
Jing Tang Jing Tang 1*Long Yang Long Yang 1Guan-Ying Yang Guan-Ying Yang 2*Yan-Hong Li Yan-Hong Li 1*You-Sen Zhu You-Sen Zhu 1*Xiao-Ming Gao Xiao-Ming Gao 1*Hui Li Hui Li 1*
  • 1 First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
  • 2 Fifth Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Region, China

The final, formatted version of the article will be published soon.

    Background: Few 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.Methods: Data 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 18189 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.Result: During a median follow-up period of 89 months, a total of 1444 (7.94%) cardiovascular deaths occurred and 5171 (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).Conclusions: Lower 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.

    Keywords: Prognostic nutritional index, Hypertension, All-cause mortality, Cardiovascular mortality, cohort study

    Received: 16 Jul 2024; Accepted: 13 Dec 2024.

    Copyright: © 2024 Tang, Yang, Yang, Li, Zhu, Gao and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jing Tang, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
    Guan-Ying Yang, Fifth Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Region, China
    Yan-Hong Li, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
    You-Sen Zhu, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
    Xiao-Ming Gao, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
    Hui Li, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

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