Association Between Weight-Adjusted Waist Index and All-Cause and Cardiovascular Mortality in Hypertensive Patients: NHANES 2001–2018

Background With the global prevalence of hypertension increasing rapidly and its inadequate treatment, this study aimed to investigate the association between weight-adjusted waist index (WWI) and mortality risks among hypertensive patients. Methods Using data from NHANES 2001–2018, we conducted a prospective cohort study of 12,146 hypertensive patients with a median follow-up of 123 months. WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). Primary outcomes were all-cause and cardiovascular disease (CVD) mortality. Analyses were adjusted for demographic characteristics, metabolic parameters, and lifestyle factors. Results During follow-up, 3,470 all-cause deaths and 940 CVD deaths occurred. After full adjustment, each unit increase in WWI was associated with higher risks of all-cause mortality (HR = 1.17, 95% CI: 1.09–1.26) and CVD mortality (HR = 1.22, 95% CI: 1.08–1.38). Compared to the lowest WWI quartile, the highest quartile showed significantly increased risks for all-cause mortality (HR = 1.34, 95% CI: 1.17–1.54) and CVD mortality (HR = 1.69, 95% CI: 1.30–2.20). Conclusion Higher WWI was independently associated with increased risks of all-cause and CVD mortality among hypertensive patients, suggesting its potential value as a simple prognostic indicator.