Association of hemoglobin-to-red blood cell distribution width ratio with all-cause and cardiovascular mortality among patients with hypertension.

BACKGROUND AND AIMS

Hemoglobin-to-red blood cell distribution width ratio (HRR) is a novel marker indicating inflammation. However, the association between HRR and mortality among hypertensive populations remains unclear.

METHODS AND RESULTS

A total of 2,185 hypertensive participants were extracted from the National Health and Nutrition Examination Survey 2011-2018. Mortality data were obtained from the National Death Index (NDI). HRR values were calculated according to the given formula. Over a median follow-up period of 68.0 months, 273 (12.5 %) of the 2,185 participants died, with 77 (3.5 %) deaths attributed to cardiovascular diseases. Survival curve analyses revealed significant decreases in the survival rate for both all-cause and cardiovascular diseases in the lower HRR groups compared to the highest one (P < 0.0001). After adjustment in the multifactorial Cox regression analyses and restricted cubic splines analyses, the lowest HRR quartile exhibited the highest risk of both all-cause and cardiovascular mortality. Time-dependent ROC analyses demonstrated that HRR possesses predictive ability for all-cause and cardiovascular mortality across different time periods, appearing superior to Hb and RDW. While stratified analyses revealed a similar trend among subgroups, the hazard ratio was notably higher in the female subgroup compared to the male subgroup.

CONCLUSION

Our findings indicate that lower HRR levels are significantly associated with higher risks of both all-cause and cardiovascular mortality among the hypertensive population, particularly among males. HRR could potentially serve as a straightforward and practical tool for identifying high-risk patients and guiding targeted interventions.