Association between plasma retinol levels and the risk of all-cause mortality in general hypertensive patients: A nested case-control study

Huan Li, Panpan He, Tengfei Lin, Huiyuan Guo, Youbao Li, Yun Song, Binyan Wang, Chengzhang Liu, Lishun Liu, Jianping Li, Yan Zhang, Yong Huo, Houqing Zhou, Yan Yang, Wenhua Ling, Xiaobin Wang, Hao Zhang, Xiping Xu, Xianhui Qin

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)906-913
Number of pages8
JournalJournal of Clinical Hypertension
Volume22
Issue number5
DOIs
StatePublished - May 1 2020

Keywords

  • all-cause mortality
  • hypertension
  • retinol
  • systolic blood pressure
  • vitamin E

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Li, H., He, P., Lin, T., Guo, H., Li, Y., Song, Y., Wang, B., Liu, C., Liu, L., Li, J., Zhang, Y., Huo, Y., Zhou, H., Yang, Y., Ling, W., Wang, X., Zhang, H., Xu, X., & Qin, X. (2020). Association between plasma retinol levels and the risk of all-cause mortality in general hypertensive patients: A nested case-control study. Journal of Clinical Hypertension, 22(5), 906-913. https://doi.org/10.1111/jch.13866