Open AccessAssociation between plasma retinol levels and the risk of all‐cause mortality in general hypertensive patients: A nested case‐control study
Author(s) -
Li Huan,
He Panpan,
Lin Tengfei,
Guo Huiyuan,
Li Youbao,
Song Yun,
Wang Binyan,
Liu Chengzhang,
Liu Lishun,
Li Jianping,
Zhang Yan,
Huo Yong,
Zhou Houqing,
Yang Yan,
Ling Wenhua,
Wang Xiaobin,
Zhang Hao,
Xu Xiping,
Qin Xianhui
Publication year - 2020
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13866
Subject(s) - medicine , nested case control study , case control study , association (psychology) , philosophy , epistemology
To evaluate the association between plasma retinol levels with all‐cause mortality and investigate the possible effect modifiers in general hypertensive patients with no previous cardiovascular disease (CVD). This case‐control study was nested in the China Stroke Primary Prevention Trial (CSPPT), a randomized, double‐blind, controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The current study included 617 cases of all‐cause mortality and 617 controls matched on age (≤1 year), sex, treatment group, and study site. All‐cause mortality was the main outcome in this analysis, which included death due to any reason. The median follow‐up duration was 4.5 years. Overall, there was a U‐shaped relation of plasma retinol with all‐cause mortality. In the threshold effect analysis, the risk of all‐cause mortality significantly decreased with the increase in plasma retinol (per 10 μg/dL increments: OR, 0.73; 95% CI: 0.61‐0.87) in participants with plasma retinol <58.3 μg/dL and increased with the increase in plasma retinol (per 10 μg/dL increments: OR, 1.08; 95% CI: 1.01‐1.16) in those with plasma retinol ≥58.3 μg/L. In participants with plasma retinol <58.3 μg/dL, a stronger inverse association was observed in those with higher time‐averaged SBP (≥140 vs <140 mm Hg; P ‐interaction = .034), or higher vitamin E levels (≥11.5 [quartile 4]; vs <11.5 μg/mL; P ‐interaction = .013). The present study demonstrated that there was a U‐shaped relationship of plasma retinol levels with the risk of all‐cause mortality in general hypertensive patients, with a turning point around 58.3 μg/dL.