ArticlePloS one2025
Relationship between the ratio of erythrocyte distribution width to albumin level and mortality in hypertensive population: Mediating role of inflammatory markers.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Cancer and Hypertension: Shared Mechanisms, Treatment Interactions, and Clinical Management.Cancer medicine · 2026Review
- Article
- Association of red cell distribution width-to-albumin ratio with mortality in adults with low muscle mass: A retrospective cohort study.The Journal of international medical research · 2026Article
- Red Cell Distribution Width-to-Albumin Ratio as a Predictor of Preeclampsia in Advanced Maternal Age: A Retrospective Cohort Study.International journal of women's health · 2026Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study examined the ratio of erythrocyte distribution width (RDW) to albumin concentration (RAR) and all-cause, cardiovascular disease (CVD), and cancer mortality in the hypertension population, focusing on the role of inflammatory markers as mediators. PATIENTS AND
methodsData from NHANES (1999-2018) were analyzed, linking National Death Index (NDI) records to mortality outcomes through December 31, 2019. A weighted sampling design categorized participants into three RAR groups. Cox regression models adjusted for demographic and clinical variables assessed the association between RAR and mortality outcomes. Mediation analyses explored the mediating role of the systemic Inflammatory response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR).
resultsAmong 26,935 participants with a median follow-up of 102 months and 6,007 deaths, elevated RAR was associated with increased risks of all-cause mortality (HR = 1.83, 95% CI: 1.76-1.90), cardiovascular disease mortality (HR = 1.81, 95% CI: 1.68-1.95), and cancer mortality (HR = 1.70, 95% CI: 1.55-1.86). Segmented regression showed a nonlinear relationship between RAR and all-cause mortality, cardiovascular mortality, and cancer mortality, and the threshold effect results showed a fold value of 4.10, with a greater HR when RAR < 4.10. Mediation analysis revealed that SIRI and NLR mediated the relationship between RAR and all-cause mortality by 8.12% and 6.00%, respectively.
conclusionIn hypertensive populations, higher RAR values are associated with increased all-cause mortality, cardiovascular mortality, and cancer mortality. Inflammation partially mediates the relationship between RAR and all-cause mortality.
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