ASSESSMENT OF CARDIOVASCULAR EVENTS IN HYPERTENSIVE PATIENTS AT RISK FOR HEART FAILURE USING GERIATRIC NUTRITIONAL RISK INDEX

Abstract

Objective: The management of hypertension in heart failure (HF) stage classification A/B is important to prevent the development of symptomatic HF. In addition, malnutrition is commonly prevalent in patients with HF. On the other hand, the relationship between malnutrition and cardiovascular prognosis in hypertensive patients at risk for HF stage A / B has not yet been fully validated. This study aimed to evaluate the association between the Geriatric Nutritional Risk Index (GNRI), one of the most commonly used nutritional indicators, and long-term outcomes in hypertensive patients at risk for HF stage A/B. Design and method: We retrospectively investigated 418 hypertensive patients at risk of HF stage A/B. GNRI was calculated at baseline as follows: GNRI = [14.89 × serum albumin (g/dl) + [41.7 × (body weight/body weight at body mass index of 22)]]. Patients were then stratified into tertiles based on GNRI. The study endpoint was a composite of cardiovascular (CV) event, including CV death, non-fatal myocardial infarction, and non-fatal stroke. Results: Over a 6.0-year median follow-up, 49 CV events occurred. Using Kaplan-Meier analysis, patients with lower GNRI group (<103.2, n = 139) showed worse prognosis compared with those with middle GNRI group (103.2 to < 111.1, n = 139) and higher GNRI group (>111.1, n = 140) (Chi-square value 10.8; p = 0.005, log-rank test). In the multivariate Cox proportional hazards analysis, lower GNRI group was significantly associated with the incidence of CV events (hazard ratio 2.23, 95% confidence incidence interval 1.14–4.39, p = 0.02) compared with higher GNRI group after adjusting for confounding factors. Conclusions: GNRI was significantly associated with CV events in hypertensive patients at risk for heart failure stage A/B. The assessment of GNRI might be a useful index to predict CV events in hypertensive patients at risk for HF stage A/B.