Body roundness index improves the predictive value of cardiovascular disease risk in hypertensive patients with obstructive sleep apnea: a cohort study

ABSTRACT

Background

Obesity, especially visceral obesity, plays an important role in the progression of cardiovascular disease (CVD). The body roundness index (BRI) is a new measure of obesity that is considered to reflect visceral obesity more comprehensively than other measures. This study aims to evaluate the relationship between BRI and CVD risk in hypertensive patients with obstructive sleep apnea (OSA) and explore its superiority in predicting CVD.

Methods

The Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CVD. The area under the curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to assess which measures of obesity had the best predictive value for CVD risk.

Results

During a median follow-up period of 6.8 years, 324 participants suffered a CVD event. After multivariable adjustment, compared with the reference group (the first tertile), the HRs (95% CI) of CVD were 1.25 (95% CI, 0.93–1.70) and 1.74 (95% CI, 1.30–2.33) for subjects in the tertile 2 and tertile 3 groups, respectively. Compared with other measurement indicators, BRI has the highest predictive value for CVD risk [AUC: 0.627, 95% CI: 0.593–0.661]. The addition of the BRI to the fully adjusted multivariate model improved the predictive power for CVD, which was validated in the continuous NRI and the IDI (all P < .05).

Conclusions

BRI was significantly associated with the risk of CVD in hypertensive patients with OSA. Furthermore, BRI may improve CVD risk prediction in hypertensive patients with OSA.

KEYWORDS:

• Hypertension
• obstructive sleep apnea
• body roundness index
• cardiovascular disease
• cohort study

Disclosure statement

The study’s authors affirm that there were no financial or commercial ties that may be viewed as having a possible conflict of interest.

Author contributions

Xintian Cai and Shuaiwei Song did complete data analysis and wrote the manuscript. Junli Hu and Qing Zhu helped perform the analysis with constructive discussions. Wenbo Yang, Jing Hong, Xiaoguang Yao, and Qin Luo contributed to the conception of the study. Nanfang Li gave guidance to the whole research process.

Data availability statement

The manuscript contains all the evidence that supports the findings. On reasonable request, the associated author will provide more in-depth information and raw data.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10641963.2023.2259132.

Additional information

Funding

Xinjiang Uygur Autonomous Region Key Laboratory Open Subjects (2022D04024).