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Associations of body roundness index with cardiovascular and all-cause mortality: NHANES 2001–2018

Journal of Human Hypertension volume 38, pages 120–127 (2024)Cite this article

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Abstract

Body roundness index (BRI) was associated with cardiovascular diseases. But the relationship between BRI with cardiovascular disease (CVD) mortality and all-cause mortality remains largely unknown in hypertensive patients. This prospective cohort study included patients with hypertension who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 through 2018, and aimed to evaluate the association between BRI with CVD mortality and all-cause mortality. A total of 15570 patients were included. Over a median follow-up of 8.0 years (interquartile range, 4.3–12.6 years), 3445 individuals died, including 1166 CVD deaths. Weighted restricted cubic spline regression results showed a nonlinear association between BRI and CVD mortality and all-cause mortality (both P for nonlinear trend <0.001). The weighted multivariate Cox proportional hazards regression showed the hazard ratio (HRs) for CVD mortality were 0.93 (95% CI: 0.84–1.03, P = 0.160) in the low levels of BRI (≤5.9) and 1.11 (95% CI: 1.05–1.19, P < 0.001) in the high levels of BRI (>5.9). Similar associations were observed for all-cause mortality, the HRs were 0.91 (95% CI: 0.87–0.96, P < 0.001) in the low levels of BRI (≤6.3) and 1.09 (95% CI: 1.05–1.13, P < 0.001) in the high levels of BRI (>6.3). This cohort study supported that BRI was nonlinearly associated with CVD mortality and all-cause mortality among patients with hypertension. The thresholds of 5.9 and 6.3 for CVD mortality and all-cause mortality, respectively, may represent intervention targets for lowering the risk of premature death, but this needs to be confirmed in large clinical trials.

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Fig. 1
Fig. 2: The distribution of BRI and its adjusted hazard ratio (HR) for mortality in NHANES 2001–2018.
Fig. 3
Fig. 4

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More information about the NHANES could be obtained at: http://www.cdc.gov/nhanes.

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Acknowledgements

Thanks to everyone who participated and contributed to the National Health and Nutrition Examination Survey. And, thanks to Zhang Jing (Shanghai Tongren Hospital) for his work on the NHANES database.

Funding

This research was funded by the National Natural Science Foundation of China (81760073) and Project of Liuzhou Science and Technology (2021CBC0108).

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Authors and Affiliations

  1. Departments of Cardiology, Liuzhou People’s Hospital, 8 Wenchang Road, Liuzhou, 545006, Guangxi, People’s Republic of China

    Lin Tao, Liu Miao, Yu-Jie Guo, Yan-Li Liu & Zhi-Jie Yang

  2. Departments of General Medicine, Liuzhou People’s Hospital, 8 Wenchang Road, Liuzhou, 545006, Guangxi, People’s Republic of China

    Li-Hong Xiao

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Contributions

Z-JY and LM conceived and designed the study. Z-JY, Y-JG, and L-HX extracted and analyzed data. LT and Y-LL wrote the manuscript. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Zhi-Jie Yang.

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The authors declare no competing interests.

Ethics approval

Study protocols for NHANES were approved by the NCHS ethnics review board (Protocol #2011–17, https://www.cdc.gov/nchs/nhanes/irba98.htm). All the participants signed the informed consent before participating in the study.

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Tao, L., Miao, L., Guo, YJ. et al. Associations of body roundness index with cardiovascular and all-cause mortality: NHANES 2001–2018. J Hum Hypertens 38, 120–127 (2024). https://doi.org/10.1038/s41371-023-00864-4

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