Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, China.
Department of Cardiology, Ruijin Hainan Hospital Shanghai Jiao Tong University School of Medicine (Hainan Boao Research Hospital), Qionghai, China.
Nutr Metab Cardiovasc Dis. 2024 Nov;34(11):2528-2536. doi: 10.1016/j.numecd.2024.06.015. Epub 2024 Jun 21.
Malnutrition is associated with poor outcomes in patients with chronic diseases. The aim of this study is to investigate the prevalence of malnutrition in patients with hypertension and relationship between malnutrition severity and long-term mortality in these patients.
The study included 11,278 patients with hypertension from the National Health and Nutrition Examination Survey database. The degree of malnutrition was assessed using the Controlled Nutritional Status score, with patients divided into normal, mild, and moderate-to-severe groups. After 10 years of follow-up, the results showed that patients who died had higher CONUT scores, poorer nutritional status, and lower albumin, total cholesterol, and lymphocytes than those who survived (P < 0.05). The Kaplan-Meier analysis revealed that patients with poor nutritional status had a significantly higher risk of all-cause death. In the Non-Lipid Lowering Drugs group, the CONUT score (hazard ratio (HR): 1.225; 95% confidence interval (CI): 1.162-1.292; P < 0.0001), as well as mild (HR: 1.532; 95% CI 1.340-1.751; P < 0.0001) and moderate-to-severe malnutrition (HR: 2.797; 95% CI: 1.441-5.428; P = 0.0024), were independent predictors of long-term mortality. The competing risk regression models showed that cardiovascular and cerebrovascular mortality increased with increasing CONUT scores. The results were robust in both subgroup and sensitivity analyses.
Malnutrition significantly impacts long-term mortality in hypertensive patients. The CONUT score may be a useful tool for assessing the nutritional status of patients with hypertension in the non-lipid-lowering population and for predicting their long-term mortality.
营养不良与慢性病患者的不良预后相关。本研究旨在调查高血压患者的营养不良患病率，以及营养不良严重程度与这些患者的长期死亡率之间的关系。
本研究纳入了来自国家健康与营养调查数据库的 11278 例高血压患者。采用控制营养状况评分（CONUT）评估营养不良程度，将患者分为正常、轻度和中重度营养不良组。经过 10 年的随访，结果显示死亡患者的 CONUT 评分更高，营养状况更差，白蛋白、总胆固醇和淋巴细胞计数更低（P<0.05）。Kaplan-Meier 分析显示，营养状况差的患者全因死亡风险显著升高。在未使用降脂药物的患者中，CONUT 评分（危险比（HR）：1.225；95%置信区间（CI）：1.162-1.292；P<0.0001），以及轻度（HR：1.532；95% CI 1.340-1.751；P<0.0001）和中重度营养不良（HR：2.797；95% CI：1.441-5.428；P=0.0024），是长期死亡率的独立预测因素。竞争风险回归模型显示，CONUT 评分升高与心血管和脑血管死亡率增加相关。亚组和敏感性分析结果稳健。
营养不良显著影响高血压患者的长期死亡率。CONUT 评分可能是评估非降脂人群中高血压患者营养状况和预测其长期死亡率的有用工具。
