The relationship between mean corpuscular hemoglobin concentration and mortality in hypertensive individuals: A population-based cohort study

Dan Li; Qing Zhang; Zhishen Ruan; Yue Zhang; Xiaohe Liu; Guihong Zhang; Hengyi Zhao; Jing Li; Bo Wu

doi:10.1371/journal.pone.0301903

The relationship between mean corpuscular hemoglobin concentration and mortality in hypertensive individuals: A population-based cohort study

PLoS One. 2024 May 9;19(5):e0301903. doi: 10.1371/journal.pone.0301903. eCollection 2024.

Authors

Dan Li¹, Qing Zhang², Zhishen Ruan¹, Yue Zhang¹, Xiaohe Liu¹, Guihong Zhang¹, Hengyi Zhao³, Jing Li⁴, Bo Wu³

Affiliations

¹ The First Clinical College, Shandong Chinese Medical University, Jinan, People's Republic of China.
² Department of Emergency, Dongying People's Hospital, Donging, People's Republic of China.
³ Department of Cardiovascular Medicine, The First Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China.
⁴ The First Affiliated Hospital of Shandong First Medical University, Jinan, People's Republic of China.

Abstract

Introduction: Hematology is an essential field for investigating the prognostic outcomes of cardiovascular diseases (CVDs). Recent research has suggested that mean corpuscular hemoglobin concentration (MCHC) is associated with a poor prognosis in several CVDs. There is no evidence of a correlation between MCHC and hypertension. Therefore, our study aimed to analyze the association of MCHC with all-cause and cardiovascular mortality in hypertensive patients.

Methods: We used cohort data from U.S. adults who participated in the National Health and Nutrition Examination Survey from 1999-2014. COX regression was applied to analyze the relationship between MCHC and all-cause and cardiovascular mortality. In addition, three models were adjusted to reduce confounding factors. We reanalyzed the data after propensity score matching (PSM) to inspect the stability of the results. Stratified analysis was additionally adopted to investigate the results of each subgroup.

Results: Our research included 15,154 individuals. During a mean follow-up period of 129 months, 30.6% of the hypertensive population succumbed to mortality. Based on previous studies, we categorized patients with MCHC ≤33mg/dl as the hypochromia group and those with >33mg/dl as the non-hypochromia group. After PSM, the hypochromia group had higher all-cause mortality (adjusted hazard ratio [HR]:1.26, 95% confidence interval [95%CI]:1.11-1.43) and cardiovascular mortality (adjusted HR:1.42, 95%CI:1.12-1.80) than the non-hypochromia group. The results of the COX regression remain stable after matching. Stratified analyses before PSM revealed an interaction of anemia in the relationship between MCHC and mortality, whereas there was no significant interaction after matching.

Conclusion: In hypertensive individuals, low MCHC was correlated with a poor prognosis. Further studies on MCHC are necessary to analyze the potential mechanisms of its poor prognosis in hypertensive populations.

Copyright: © 2024 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cardiovascular Diseases / blood
Cardiovascular Diseases / mortality
Cohort Studies
Erythrocyte Indices*
Female
Hemoglobins* / analysis
Hemoglobins* / metabolism
Humans
Hypertension* / blood
Hypertension* / mortality
Male
Middle Aged
Nutrition Surveys
Prognosis
Proportional Hazards Models

Substances

Hemoglobins

Grants and funding

This study is supported by the 2022 Special Project on the Inheritance of Ancient Literature and Special Techniques of Chinese Medicine (0686-2211CA080200Z), awarded to BW. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.