Hemoglobin specific volume width promotes the prevalence and poor long-term prognosis of American adult hypertensive patients: the NHANES 1999-2020

Abstract

Background: Hypertensive patients are always accompanied by erythrocyte dysfunction. However, current erythrocyte-related indicators can’t explain hypertension's prevalence and long-term prognosis. Therefore, hemoglobin specific volume width (HSW) was first created to explain this phenomenon. Methods: 59,867 adult participants from National Health and Nutrition Examination Survey (NMAHES) were included. HSW’s quartiles were determined with Q1 [1.88,3.64] cL/g, Q2 (3.64,3.84] cL/g , Q3 (3.84,4.11] cL/g, and Q4 (4.11,11.74] cL/g. 21,006 hypertensive patients had a whole following time 97 (51, 151) months, 15,519 hypertensive patients were alive, and 5,487 were dead. The relationship between HSW and hypertension was analyzed. Results: Among Controls n=35,677 and Hypertensive patients n=24,190, the percentages of hypertension in quartiles of HSW (Q1, Q2, Q3, and Q4) were 28.59%, 33.35%, 39.37%, and 47.74%. Adjusted odds ratio (OR) in HSW was still significant, 1.23 (95% CI 1.11,1.36). Among dead (n=5,487) and alive hypertensive patients (n=15,519), the percentages of hypertensive mortality in quartiles of HSW were 17.66%, 20.46%, 20.78%, and 25.02%. The adjusted HSW hazard ratio (HR) was 1.91(95%CI 1.69,2.16). Processing Q1 as reference, the HR for Q4 was 2.35 (95% CI 2.06, 2.69). Males had a higher risk (HR: 1.53 95% CI 1.24,1.89) of poor prognosis than females (HR: 1.48 95% CI 1.17,1.87). Individuals <=60 years old (HR: 2.25 95% CI 1.78,2.85) had a higher risk of poor prognosis than those >60. Hypertensive patients with HSW > 3.89 cL/ghad a poor prognosis than HSW <= 3.89 cL/g. Conclusions: HSW is an innovative independent risk factor for hypertensive prevalence and long-term prognosis.