Association between red blood cell distribution width-to-albumin ratio and cardiovascular disease mortality and all-cause mortality in patients with hypertension: An observational study

This study aimed to investigate the relationship between red blood cell distribution width to-albumin ratio (RAR) and mortality risk among patients with hypertension, thereby providing a foundation for early assessment in this population. A total of 6830 adult patients with hypertension were included in this study. To explore the association between RAR levels and 10-year all-cause mortality in patients with hypertension, smooth curve fitting and Kaplan-Meier (KM) curve analysis were employed. Additionally, Cox regression analysis was conducted to evaluate the impact of RAR on all-cause mortality. The robustness of the findings was confirmed through stratified analysis and interaction tests. A competing risk model was also utilized to assess the relationship between RAR and cardiovascular as well as cerebrovascular mortality in patients with hypertension. The result of smooth curve fitting showed that 10-year all-cause mortality rate among patients with hypertension progressively increased with higher RAR levels. After fully adjusting for confounding factors, RAR remained significantly associated with a 10-year all-cause mortality risk in patients with hypertension (HR = 1.69, 95% confidence interval: 1.50-1.8, P < .001). Furthermore, the competing risk model revealed a similar association between RAR and both cardiovascular and cerebrovascular mortality in this group. With RAR levels rise, the risk of all-cause mortality and mortality due to cardiovascular disease also escalates. This study suggest that RAR may serve as a useful tool for assessing the prognosis of patients with hypertension.