Qin Huali, Shen Li, Xu Danyan
Department of Internal Cardiovascular Medicine, Second Xiangya Hospital, Central South University, Changsha, China.
Front Nutr. 2024 May 13;11:1371928. doi: 10.3389/fnut.2024.1371928. eCollection 2024.
The objective of this study is to assess the correlation between composite dietary antioxidant index (CDAI) with all-cause mortality and cause-specific mortality in adults with hypertension.
The cohort study comprised adult participants with hypertension from the NHANES database, spanning 9 cycles from 2001 to 2018. Follow-up was conducted until December 31, 2019. Multi-variable Cox regression analysis was utilized to ascertain hazard ratios (HR) and their corresponding 95% confidence intervals, evaluating the relationship between CDAI and the risks of all-cause and cause-specific mortality. To further investigate the association between CDAI and mortality rates in adults with hypertension, Kaplan-Meier survival curves, restricted cubic splines (RCS), subgroup analyses and sensitivity analyses were employed.
The analysis included 16,713 adults with hypertension (mean age 56.93 ± 0.23 years, 8,327 [49.61%] male). During the mean follow-up time 102.11 ± 1.22 months, with 3,908 (18.08%) all-cause mortality occurred, 1,082 (4.84%) cardiovascular mortality and 833 (3.80%) cancer mortality. Compared to the lowest quartile of CDAI, the weighted multivariate hazard ratios of participants in the highest quartile was 0.77 (95% CI, 0.68-0.87) for all-cause mortality, 0.83 (95% CI, 0.67-1.04) for cardiovascular mortality, and 0.64 (95% CI, 0.50-0.82) for cancer mortality. RCS analysis demonstrated a nonlinear association of CDAI with all-cause and cancer mortality, and a linear association between CDAI and cardiovascular mortality. The results were robust in subgroup analyses and sensitivity analyses.
Higher CDAI is associated with reduced all-cause mortality, cardiovascular mortality, and cancer mortality in hypertensive adults. Our findings highlight the importance of an antioxidant diet in improving outcomes in adults with hypertension.
本研究旨在评估复合膳食抗氧化指数（CDAI）与高血压成人全因死亡率及特定病因死亡率之间的相关性。
队列研究纳入了来自美国国家健康与营养检查调查（NHANES）数据库的成年高血压患者，涵盖2001年至2018年的9个周期。随访至2019年12月31日。采用多变量Cox回归分析确定风险比（HR）及其相应的95%置信区间，评估CDAI与全因及特定病因死亡率风险之间的关系。为进一步研究CDAI与高血压成人死亡率之间的关联，采用了Kaplan-Meier生存曲线、限制性立方样条（RCS）、亚组分析和敏感性分析。
分析纳入了16713例成年高血压患者（平均年龄56.93±0.23岁，8327例[49.61%]为男性）。在平均随访时间102.11±1.22个月期间，发生全因死亡3908例（18.08%），心血管死亡1082例（4.84%），癌症死亡833例（3.80%）。与CDAI最低四分位数相比，最高四分位数参与者的全因死亡加权多变量风险比为0.77（95%CI，0.68 - 0.87），心血管死亡为0.83（95%CI，0.67 - 1.04），癌症死亡为0.64（95%CI，0.50 - 0.82）。RCS分析表明CDAI与全因及癌症死亡率呈非线性关联，与心血管死亡率呈线性关联。结果在亚组分析和敏感性分析中具有稳健性。
较高的CDAI与高血压成人全因死亡率、心血管死亡率和癌症死亡率降低相关。我们的研究结果凸显了抗氧化饮食在改善高血压成人预后方面的重要性。
