BACKGROUND Oxidative stress is closely associated with hypertensive outcomes.The oxidative balance score(OBS)measures oxidative stress exposure from dietary and lifestyle elements.The objective of this study was to in...BACKGROUND Oxidative stress is closely associated with hypertensive outcomes.The oxidative balance score(OBS)measures oxidative stress exposure from dietary and lifestyle elements.The objective of this study was to investigate the association between OBS and mortality in hypertensive patients.METHODS This study included 7823 hypertensive patients from the National Health and Nutrition Examination Survey(NHA-NES)1999-2014.Several models,including Cox regression,restricted cubic splines(RCS),Kaplan-Meier survival analysis,subgroup,and sensitivity analyses,were exploited to investigate the relationship between OBS and the risk of mortality.RESULTS Controlling for all potential confounders,a significantly inverse association was observed between elevated OBS and all-cause[hazard ratio(HR)=0.90,95%CI:0.85-0.95]and cardiovascular mortality(HR=0.85,95%CI:0.75-0.95).With adjustment for covariates,significant associations between lifestyle OBS and mortality risks diminished,whereas associations between dietary OBS and these mortality risks remained robust(all-cause mortality:HR=0.91,95%CI:0.86-0.96;cardiovascular mortality:HR=0.85,95%CI:0.76-0.96).RCS demonstrated a linear relationship between OBS and all-cause and cardiovascular mortality risk(P_(nonlinear)=0.088 and P_(nonlinear)=0.447,respectively).Kaplan-Meier curves demonstrated that the mortality rate was lower with a high OBS(P<0.001).The consistency of the association was demonstrated in subgroup and sensitivity analyses.RCS after stratification showed that among current drinkers,those with higher OBS had a lower risk of mortality compared with former or never drinkers.CONCLUSIONS In hypertensive individuals,there was a negative association between OBS and all-cause and cardiovascular mortality.Encouraging hypertensive individuals,especially those currently drinking,to maintain high levels of OBS may be beneficial in improving their prognosis.展开更多
BACKGROUND The cardiovascular hazards of total homocysteine(tHcy)are long known.In addition,despite the acknow-ledgment on the importance of low ankle-brachial index(ABI)(<0.9),borderline ABI(0.91-0.99)was once com...BACKGROUND The cardiovascular hazards of total homocysteine(tHcy)are long known.In addition,despite the acknow-ledgment on the importance of low ankle-brachial index(ABI)(<0.9),borderline ABI(0.91-0.99)was once commonly overlooked.This study aims to explore the independent and joint effect of tHcy level and borderline ABI on all-cause death in hypertensive population.METHODS This study included 10,538 participants from China H-type Hypertension Registry Study.ABI was described into two groups:normal ABI(1.00-1.40)and borderline ABI.tHcy level was also divided into two groups:<15.02 and≥15.02μmo/L.Four groups were analyzed,using COX proportional hazard regression model,separately and pairwise to observe the independ-ent and joint effect on all-cause death.RESULTS A total of 126(1.2%)deaths were observed in the 1.7 years follow-up time.Borderline ABI has a higher predicted risk of death than normal ABI(HR=1.87,95%CI:1.17-3.00)after adjusting for potential covariates.Compare with tHcy level<15.02μmo/L(low tHcy),those with tHcy≥15.02μmo/L(high tHcy)had higher risk to event outcome(HR=1.99,95%CI:1.30-3.05).According to the cumulative hazard curve,group with borderline ABI and high tHcy level has significantly higher altitude and larger increasing rate over follow-up period compare to other groups.Among those with borderline ABI,participants with high tHcy had higher death risk than those with low tHcy,nevertheless,no significant different between borderline and normal ABI among those with low tHcy levels.CONCLUSIONS Borderline ABI and tHcy level both have independent predictive value on all-cause death.The combined group of borderline ABI and high tHcy has highest risk factor of outcomes,which suggested the mutual additive value of border-line ABI and tHcy.More attention should be given to the importance of borderline ABI in hypertensive population,especially with elevated tHcy level.展开更多
基金supported by the National Natural Science Foundation of China(No.81960074)the Natural Science Foundation-Outstanding Youth Fund Project of Jiangxi Province(No.20232ACB216006)。
文摘BACKGROUND Oxidative stress is closely associated with hypertensive outcomes.The oxidative balance score(OBS)measures oxidative stress exposure from dietary and lifestyle elements.The objective of this study was to investigate the association between OBS and mortality in hypertensive patients.METHODS This study included 7823 hypertensive patients from the National Health and Nutrition Examination Survey(NHA-NES)1999-2014.Several models,including Cox regression,restricted cubic splines(RCS),Kaplan-Meier survival analysis,subgroup,and sensitivity analyses,were exploited to investigate the relationship between OBS and the risk of mortality.RESULTS Controlling for all potential confounders,a significantly inverse association was observed between elevated OBS and all-cause[hazard ratio(HR)=0.90,95%CI:0.85-0.95]and cardiovascular mortality(HR=0.85,95%CI:0.75-0.95).With adjustment for covariates,significant associations between lifestyle OBS and mortality risks diminished,whereas associations between dietary OBS and these mortality risks remained robust(all-cause mortality:HR=0.91,95%CI:0.86-0.96;cardiovascular mortality:HR=0.85,95%CI:0.76-0.96).RCS demonstrated a linear relationship between OBS and all-cause and cardiovascular mortality risk(P_(nonlinear)=0.088 and P_(nonlinear)=0.447,respectively).Kaplan-Meier curves demonstrated that the mortality rate was lower with a high OBS(P<0.001).The consistency of the association was demonstrated in subgroup and sensitivity analyses.RCS after stratification showed that among current drinkers,those with higher OBS had a lower risk of mortality compared with former or never drinkers.CONCLUSIONS In hypertensive individuals,there was a negative association between OBS and all-cause and cardiovascular mortality.Encouraging hypertensive individuals,especially those currently drinking,to maintain high levels of OBS may be beneficial in improving their prognosis.
基金funded by the Key R&D ProjectsJiangxi [20203BBGL73173]+4 种基金the National Natural Science Foundation of China [81960074]Project of Jiangxi Provincial Health Commission [202130440]5511 Science and Technology Innovation Talent Project of Jiangxi Province (CN)[20165BCD41005]Jiangxi Provincial Natural Science Foundation[20212ACB206019]the Second Affiliated Hospital of Nanchang University[2016YNQN12034, 2019YNLZ12010, IIT-I-2021-002, 2021YNFY2024]
文摘BACKGROUND The cardiovascular hazards of total homocysteine(tHcy)are long known.In addition,despite the acknow-ledgment on the importance of low ankle-brachial index(ABI)(<0.9),borderline ABI(0.91-0.99)was once commonly overlooked.This study aims to explore the independent and joint effect of tHcy level and borderline ABI on all-cause death in hypertensive population.METHODS This study included 10,538 participants from China H-type Hypertension Registry Study.ABI was described into two groups:normal ABI(1.00-1.40)and borderline ABI.tHcy level was also divided into two groups:<15.02 and≥15.02μmo/L.Four groups were analyzed,using COX proportional hazard regression model,separately and pairwise to observe the independ-ent and joint effect on all-cause death.RESULTS A total of 126(1.2%)deaths were observed in the 1.7 years follow-up time.Borderline ABI has a higher predicted risk of death than normal ABI(HR=1.87,95%CI:1.17-3.00)after adjusting for potential covariates.Compare with tHcy level<15.02μmo/L(low tHcy),those with tHcy≥15.02μmo/L(high tHcy)had higher risk to event outcome(HR=1.99,95%CI:1.30-3.05).According to the cumulative hazard curve,group with borderline ABI and high tHcy level has significantly higher altitude and larger increasing rate over follow-up period compare to other groups.Among those with borderline ABI,participants with high tHcy had higher death risk than those with low tHcy,nevertheless,no significant different between borderline and normal ABI among those with low tHcy levels.CONCLUSIONS Borderline ABI and tHcy level both have independent predictive value on all-cause death.The combined group of borderline ABI and high tHcy has highest risk factor of outcomes,which suggested the mutual additive value of border-line ABI and tHcy.More attention should be given to the importance of borderline ABI in hypertensive population,especially with elevated tHcy level.
