Obesity, malnutrition, and the prevalence and outcome of hypertension: Evidence from the National Health and Nutrition Examination Survey
BackgroundNutritionally unhealthy obesity is a newly introduced phenotype characterized by a combined condition of malnutrition and obesity. This study aims to explore the combined influence of obesity and nutritional status on the prevalence and outcome of hypertension.MethodsParticipants collected...
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| Format: | Article |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1043491/full |
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| author | Heng-Zhi Zhang Heng-Zhi Zhang Yi-Han Wang Yi-Han Wang Ying-Lin Ge Shu-Yu Wang Jin-Yu Sun Lu-Lu Chen Shuang Su Ying Sun |
| author_facet | Heng-Zhi Zhang Heng-Zhi Zhang Yi-Han Wang Yi-Han Wang Ying-Lin Ge Shu-Yu Wang Jin-Yu Sun Lu-Lu Chen Shuang Su Ying Sun |
| author_sort | Heng-Zhi Zhang |
| collection | DOAJ |
| description | BackgroundNutritionally unhealthy obesity is a newly introduced phenotype characterized by a combined condition of malnutrition and obesity. This study aims to explore the combined influence of obesity and nutritional status on the prevalence and outcome of hypertension.MethodsParticipants collected from the National Health and Nutrition Examination Survey (NHANES) database were divided into four subgroups according to their obesity and nutritional conditions, as defined by waist circumference and serum albumin concentration. The lean-well-nourished was set as the reference group. Logistic regression models were applied to evaluate the hypertension risk. Kaplan–Meier analysis and Cox proportional hazard regression models were used to assess the survival curve and outcome risk of participants with hypertension.ResultsA total of 28,554 participants with 10,625 hypertension patients were included in the analysis. The lean-malnourished group showed a lower hypertension risk (odds ratio [OR] 0.85, 95% confidence interval [CI]: 0.77–0.94), while the obese-well-nourished condition elevated the risk (OR 1.47, 95% CI: 1.3–1.67). Two malnourished groups had higher mortality risks (HR 1.42, 95% CI: 1.12–1.80 and HR 1.31, 95% CI: 1.03–1.69 for the lean and obese, respectively) than the reference group. The outcome risk of the obese-well-nourished group (HR 1.02, 95% CI: 0.76–1.36) was similar to the lean-well-nourished.ConclusionMalnutrition was associated with a lower risk of developing hypertension in both lean and obese participants, but it was associated with a worse outcome once the hypertension is present. The lean-malnourished hypertension patients had the highest all-cause mortality risk followed by the obese-malnourished. The obese-well-nourished hypertension patients showed a similar mortality risk to the lean-well-nourished hypertension patients. |
| first_indexed | 2024-04-10T06:17:53Z |
| format | Article |
| id | doaj.art-ec37c7dc90f843ff9592029d432facec |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-10T06:17:53Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-ec37c7dc90f843ff9592029d432facec2023-03-02T06:41:38ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-03-011010.3389/fcvm.2023.10434911043491Obesity, malnutrition, and the prevalence and outcome of hypertension: Evidence from the National Health and Nutrition Examination SurveyHeng-Zhi Zhang0Heng-Zhi Zhang1Yi-Han Wang2Yi-Han Wang3Ying-Lin Ge4Shu-Yu Wang5Jin-Yu Sun6Lu-Lu Chen7Shuang Su8Ying Sun9Department of Burn and Plastic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, ChinaThe First Clinical Medicine College, Nanjing Medical University, Nanjing, ChinaDepartment of Burn and Plastic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, ChinaThe First Clinical Medicine College, Nanjing Medical University, Nanjing, ChinaDepartment of Biomedical Engineering, College of Medicine, Tianjin University, Tianjin, ChinaThe First Clinical Medicine College, Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Anatomy, Histology, and Embryology, Nanjing Medical University, Nanjing, ChinaNanjing Pukou Central Hospital, Pukou Branch Hospital of Jiangsu Province Hospital, Nanjing, ChinaDepartment of Burn and Plastic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, ChinaBackgroundNutritionally unhealthy obesity is a newly introduced phenotype characterized by a combined condition of malnutrition and obesity. This study aims to explore the combined influence of obesity and nutritional status on the prevalence and outcome of hypertension.MethodsParticipants collected from the National Health and Nutrition Examination Survey (NHANES) database were divided into four subgroups according to their obesity and nutritional conditions, as defined by waist circumference and serum albumin concentration. The lean-well-nourished was set as the reference group. Logistic regression models were applied to evaluate the hypertension risk. Kaplan–Meier analysis and Cox proportional hazard regression models were used to assess the survival curve and outcome risk of participants with hypertension.ResultsA total of 28,554 participants with 10,625 hypertension patients were included in the analysis. The lean-malnourished group showed a lower hypertension risk (odds ratio [OR] 0.85, 95% confidence interval [CI]: 0.77–0.94), while the obese-well-nourished condition elevated the risk (OR 1.47, 95% CI: 1.3–1.67). Two malnourished groups had higher mortality risks (HR 1.42, 95% CI: 1.12–1.80 and HR 1.31, 95% CI: 1.03–1.69 for the lean and obese, respectively) than the reference group. The outcome risk of the obese-well-nourished group (HR 1.02, 95% CI: 0.76–1.36) was similar to the lean-well-nourished.ConclusionMalnutrition was associated with a lower risk of developing hypertension in both lean and obese participants, but it was associated with a worse outcome once the hypertension is present. The lean-malnourished hypertension patients had the highest all-cause mortality risk followed by the obese-malnourished. The obese-well-nourished hypertension patients showed a similar mortality risk to the lean-well-nourished hypertension patients.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1043491/fullhypertensionobesitymalnutritionwaist circumferencedouble burden of malnutrition |
| spellingShingle | Heng-Zhi Zhang Heng-Zhi Zhang Yi-Han Wang Yi-Han Wang Ying-Lin Ge Shu-Yu Wang Jin-Yu Sun Lu-Lu Chen Shuang Su Ying Sun Obesity, malnutrition, and the prevalence and outcome of hypertension: Evidence from the National Health and Nutrition Examination Survey Frontiers in Cardiovascular Medicine hypertension obesity malnutrition waist circumference double burden of malnutrition |
| title | Obesity, malnutrition, and the prevalence and outcome of hypertension: Evidence from the National Health and Nutrition Examination Survey |
| title_full | Obesity, malnutrition, and the prevalence and outcome of hypertension: Evidence from the National Health and Nutrition Examination Survey |
| title_fullStr | Obesity, malnutrition, and the prevalence and outcome of hypertension: Evidence from the National Health and Nutrition Examination Survey |
| title_full_unstemmed | Obesity, malnutrition, and the prevalence and outcome of hypertension: Evidence from the National Health and Nutrition Examination Survey |
| title_short | Obesity, malnutrition, and the prevalence and outcome of hypertension: Evidence from the National Health and Nutrition Examination Survey |
| title_sort | obesity malnutrition and the prevalence and outcome of hypertension evidence from the national health and nutrition examination survey |
| topic | hypertension obesity malnutrition waist circumference double burden of malnutrition |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1043491/full |
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