Constipation and Cardiovascular Mortality Risk in Patients With Hypertension: A Long‐Term Cohort Study

<b>Background:</b> Whether constipation serves as a risk factor for mortality in hypertensive patients remains an open question. The purpose of the study was to investigate the association of constipation in hypertensive patients with the prognosis for mortality. <b>Methods:</b> The study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in 2009-2010 involving hypertensive individuals. Constipation was self-reported over the past 12 months. Cox regression analyses, adjusted for age, sex, and race/ethnicity, were employed to assess the association between constipation and all-cause mortality, as well as cardiovascular mortality. Subgroup and sensitivity analyses were conducted to explore variations in the relationship across different demographic and comorbidity groups. <b>Results:</b> Of the 5199 individuals, 1285 had constipation. Hypertensive patients with constipation exhibited an increased risk of all-cause mortality (HR, 1.40, 95% CI, 0.99 to 1.97, <i>p</i>=0.06) and cardiovascular mortality (HR, 1.83, 95% CI, 1.09 to 3.07, <i>p</i>=0.02) compared to nonconstipated patients. The Kaplan-Meier survival curves also reflected higher rates of all-cause mortality (92.71% vs. 89.18%, <i>p</i> < 0.001) and cardiovascular mortality (97.87% vs. 96.44%, <i>p</i>=0.004) in the constipation group. Among hypertensive patients with a PIR ≤ 100, those with constipation exhibited significantly higher all-cause mortality risk than those without (HR 1.95; 95% CI 1.14-2.67; <i>p</i> < 0.001). These patients also demonstrated increased cardiovascular mortality risk (HR 1.93; 95% CI 1.12-3.40; <i>p</i>=0.019). <b>Conclusion:</b> Constipation shows a significant association with increased cardiovascular mortality risk in hypertensive patients.