Prevalence and Prognostic Significance of Malnutrition in Hypertensive Patients in a Community Setting.

Zhi-Wen Yang,Bing-Qi Fu,Ji-Yan Chen,Xue-Biao Wei,Dan-Qing Yu

doi:10.3389/fnut.2022.822376

Abstract

BackgroundMalnutrition is a significantly poor prognostic factor for a variety of cardiovascular diseases. However, its prevalence and prognostic value in hypertensive patients is still unclear. The present study sought to determine the prevalence and prognostic value of malnutrition in hypertensive patients in a community setting.MethodsWe included 9,949 hypertensive patients from the National Health and Nutrition Examination Survey (NHANES) (2005–2014). The Controlling Nutritional Status (CONUT) score, the Nutritional Risk Index (NRI), and the Naples Prognostic Score (NPS) were applied to assess the nutritional status of participants. A Cox regression model was established to examine the association between malnutrition and cardiovascular and all-cause mortality.ResultsIn all, 19.9, 3.9, and 82.9% hypertensive patients were considered to have malnutrition as evaluated by the CONUT, NRI, and NPS, respectively. Malnutrition assessed by CONUT and NRI was independently associated with cardiovascular mortality (HR [95% CI]) for mild and moderate-to-severe degree of malnutrition, respectively: 1.41 (1.04–1.91) and 5.79 (2.34–14.29) for CONUT; 2.60 (1.34–5.07) and 3.30 (1.66–6.56) for NRI (all P < 0.05), and for all-cause mortality (HR [95% CI]) for mild and moderate-to-severe degree of malnutrition, respectively: 1.48 (1.30–1.70) and 4.87 (3.40–6.98) for CONUT; 1.72 (1.24–2.39) and 2.60 (1.96–3.44) for NRI (all P < 0.01). Naples Prognostic Score could only independently predict all-cause mortality.ConclusionsMalnutrition was common among hypertensive patients and was closely associated with both long-term cardiovascular and all-cause mortality.

Highlights

The effect of nutritional state on a variety of cardiovascular diseases is the subject of increasing concern, as it is modifiable compared to other clinical variables [1]
Malnutrition assessed by Controlling Nutritional Status (CONUT) and Nutritional Risk Index (NRI) was independently associated with cardiovascular mortality (HR [95% confidence intervals (CIs)]) for mild and moderate-to-severe degree of malnutrition, respectively: 1.41 (1.04–1.91) and 5.79 (2.34–14.29) for CONUT; 2.60 (1.34–5.07) and 3.30 (1.66–6.56) for NRI, and for all-cause mortality (HR [95% CI]) for mild and moderate-to-severe degree of malnutrition, respectively: 1.48 (1.30–1.70) and 4.87 (3.40–6.98) for CONUT; 1.72 (1.24–2.39) and 2.60 (1.96–3.44) for NRI
Malnutrition was common among hypertensive patients and was closely associated with both long-term cardiovascular and all-cause mortality

Summary

Introduction

The effect of nutritional state on a variety of cardiovascular diseases is the subject of increasing concern, as it is modifiable compared to other clinical variables [1]. Recent studies have reported that malnutrition is a significantly poor prognostic factor of acute coronary artery disease, heart failure, atrial fibrillation, and valvular heart disease [3–5]. The aged-standardized prevalence of hypertension reported on 2015 was 24.1% for men and 20.1% for women globally [8]. Nutritional factors such as nutrient intake, blood lipids, and high Body Mass Index (BMI) have been shown to be associated with blood pressure control and mortality [9, 10]. Malnutrition is a significantly poor prognostic factor for a variety of cardiovascular diseases. The present study sought to determine the prevalence and prognostic value of malnutrition in hypertensive patients in a community setting

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