Hemoglobin specific volume width might promote the prevalence and poor long-term prognosis of American cardiovascular disease adult patients: the NHANES 1999-2020

Abstract

BackgroundCardiovascular disease (CVD) patients are always accompanied by erythrocyte dysfunction. However, current erythrocyte-related indicators can’t explain the prevalence and long-term prognosis of CVD. Therefore, hemoglobin specific volume width (HSW) was first created to explain this phenomenon.MethodsHSW’s quartiles were determined with Q1 [1.88,3.64] cL/g, Q2 (3.64,3.85] cL/g, Q3 (3.85,4.11] cL/g, and Q4 (4.11,11.74] cL/g. Among the 57,894 participants derived from National Health and Nutrition Examination Survey (NMAHES), 5,623 CVD patients had a whole following time (median 79 months). Logistic regression, Cox regression, Kaplan–Meier curves, and restricted cubic spline were utilized for analysis.ResultsAmong the non-CVD (n=51,243) and CVD (n=6,651) individuals, the percentages of CVD in quartiles of HSW (Q1, Q2, Q3, and Q4) were 4.95%, 7.11%, 10.51%, and 16.14% (P< 0.0001). Adjusted odds ratio (OR) was still significant, 1.46 (95% CI 1.33, 1.60). Processing Q1 as reference, the adjusted ORs for Q3 and Q4 were 1.19(95% CI 1.05,1.35) and 1.54 (95% CI 1.36,1.73). Females had a higher risk (OR 1.49, 95% CI 1.32, 1.68) of CVD than males with increasing HSW. Diabetes mellitus (DM) patients had the highest risk of CVD (OR 1.54, 95% CI 1.30,1.84) than preDM or healthy individuals. Among dead (n=2,517) and alive CVD (n=3,106) patients, the adjusted HSW hazard ratio (HR) was 1.70 (95% CI 1.48,1.95). An inverse L-curve with an inflexion point of 3.96 was observed between HR and CVD. CVD patients with HSW > 3.96 had a poor prognosis than HSW <= 3.96.ConclusionsHSW is a novel risk for CVD prevalence and long-term prognosis. Females and DM patients have a higher risk of CVD when HSW increases.