HALP score: A powerful and promising index for predicting prognosis among hypertension adults

Previous reports have highlighted that inflammation and poor nutritional condition are closely related to a poor prognosis for hypertension. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a promising index to reflect potential interaction and synergistic effects between inflammation and nutrition. Our research objective is to excavate the HALP score and specific mortality outcomes of hypertensive adults. This study was a linked-mortality cohort analysis based on participants from the National Health and Nutrition Examination Survey 1999 to 2018. The HALP score was calculated based on 4 blood parameters, and hypertension was determined by blood pressure measurement, questionnaire, and prescription. All-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality were defined as the primary outcomes of this study. Cox regression analyses were conducted to estimate the hazard ratio (HR) and 95% confidence interval (CI). Restricted cubic spline analysis and subgroup analyses were performed to assess the robustness of our findings. Our research enrolled 20,256 hypertensive adults (mean age = 53.78 ± 0.22 years), including 10,808 (53.36%) males and 9448 (46.64%) females. During 189,593 person-years of follow-up, 4432 all-cause deaths were documented, with 1227 attributed to CVD and 966 to cancer. When compared with hypertensive participants in the lowest quartile (Q1) of the HALP score, those in the highest quartile (Q4) exhibited a 30% reduced risk of all-cause mortality (HR = 0.70, 95% CI = 0.64-0.77, P trend < .001), a 39% lower risk of CVD mortality (HR = 0.61, 95% CI = 0.49-0.76, P trend < .001), and a 22% lower risk of cancer mortality (HR = 0.78, 95% CI = 0.63-0.96, P trend = .086), respectively. Restricted cubic spline analysis revealed an L-shaped association between the HALP score and each of these mortality outcomes. Higher HALP scores correlated with lower risks of mortality from all causes, CVD, and cancer among adults with hypertension. These findings implicate that the HALP score could be a promising and powerful marker to predict prognosis among hypertensive adults in clinical practice.