Alcohol drinking triggered decrease of oxidative balance sc-ore is associated with high all-cause and cardiovascular mor-tality in hypertensive individuals:findings from NHANES 1999-2014OA

BACKGROUND Oxidative stress is closely associated with hypertensive outcomes.The oxidative balance score(OBS)measu-res oxidative stress exposure from dietary and lifestyle elements.The objective of this study was to investigate the association be-tween OBS and mortality in hypertensive patients. METHODS This study included 7823 hypertensive patients from the National Health and Nutrition Examination Survey(NHA-NES)1999-2014.Several models,including Cox regression,restricted cubic splines(RCS),Kaplan-Meier survival analysis,subgr-oup,and sensitivity analyses,were exploited to investigate the relationship between OBS and the risk of mortality. RESULTS Controlling for all potential confounders,a significantly inverse association was observed between elevated OBS and all-cause[hazard ratio(HR)=0.90,95％CI:0.85-0.95]and cardiovascular mortality(HR=0.85,95％CI:0.75-0.95).With adjust-ment for covariates,significant associations between lifestyle OBS and mortality risks diminished,whereas associations between dietary OBS and these mortality risks remained robust(all-cause mortality:HR=0.91,95％CI:0.86-0.96;cardiovascular mortal-ity:HR=0.85,95％CI:0.76-0.96).RCS demonstrated a linear relationship between OBS and all-cause and cardiovascular mortal-ity risk(Pnonlinear=0.088 and Pnonlinear=0.447,respectively).Kaplan-Meier curves demonstrated that the mortality rate was lower with a high OBS(P＜0.001).The consistency of the association was demonstrated in subgroup and sensitivity analyses.RCS after stratification showed that among current drinkers,those with higher OBS had a lower risk of mortality compared with former or never drinkers. CONCLUSIONS In hypertensive individuals,there was a negative association between OBS and all-cause and cardiovascular mortality.Encouraging hypertensive individuals,especially those currently drinking,to maintain high levels of OBS may be bene-ficial in improving their prognosis.