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Study Suggests BMI Does Not Indicate Length of Hospital Stay for Patients With Hypertension
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Key Takeaways
- BMI is not a significant predictor of hospital stay length for hypertensive patients in cardiology units.
- LDL, HDL, and hsCRP levels predict hospital stay length for women; LDL, HDL, and TC for men.
Certain laboratory tests indicate stronger predictions for hospital stay, suggesting pharmaceutical intervention could help reduce the length of cardiovascular-related hospital stay.
Body mass index (BMI) at the time of patient admission to the cardiology unit is not a significant predictor of length of hospital stay for women or men with hypertension. BMI is widely used in clinical practice, and investigators aimed to determine whether BMI impacted the length of hospital stay for patients with hypertension who were admitted to the cardiology unit, according to the study published in Vascular Health and Risk Management.1
Hypertension, Obesity, Overweight, Weight Management, Cardiovascular disease | Image Credit: © Rasi | stock.adobe.com
According to the World Health Organization (WHO), approximately 1.28 billion adults worldwide aged 20 to 79 years have hypertension—most living in low- and middle-income countries. Approximately 46% are unaware they have the condition, and 42% are diagnosed and treated. In a review from 2020, investigators note that obesity has been linked to adverse cardiovascular outcomes, with the disease accounting for approximately 65% to 78% of cases of primary hypertension. There are many factors that come into play with obesity and hypertension, including sympathetic nervous system overactivation, stimulation of the renin-angiotensin-aldosterone system, and insulin resistance. These methods are complex, and weight loss is considered a primary goal of treatment for obesity-related hypertension.2,3
Hypertension is the leading cause of premature death, according to WHO. Obesity has more than doubled since 1990 and has been linked to many health issues, including cardiovascular disease, diabetes, neurological disorders, and even some cancers. Although dietary interventions for obesity are common, there are also pharmaceutical interventions, including glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide (Wegovy; Novo Nordisk) and tirzepatide (Zepbound; Eli Lilly). Both GLP-1 medications have shown improvements in weight management as well as some cardiovascular benefits.4,5
In the current study, investigators aimed to determine if sex differences exist regarding BMI at the time of admission to the cardiology unit and if it could impact length of hospital stay for these patients. The study was retrospective in nature and included patients who were admitted to the Cardiology Department in the University Hospital in Wroclaw, Poland, between January 2017 and June 2021. Patients had a diagnosis of arterial hypertension, were 18 years or older, and were urgently admitted. Data included BMI, length of hospital stay, hypertension grade, comorbidities—heart failure, diabetes, chronic kidney disease, history of cerebral stroke, myocardial infarction—and laboratory tests including triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), high-sensitivity C-reactive protein (hsCRP), thyroid-stimulating hormone (TSH), and hemoglobin A1c, among others. Obesity was categorized as BMI of 30 kg/m2 or greater, overweight as 25 kg/m2 to 29.9 kg/m2, normal weight as 18.5 to 24.9 kg/m2, and underweight as less than 18.5 kg/m2.1
A total of 589 patients were included in the study, with 54.8% women, a mean age of 63.3 years, and mean BMI of 28.8 kg/m2. Approximately 31.9% of individuals were classified as having overweight and 30.9% were categorized as having obesity. Approximately 19.4% were of normal weight and 1.2% were underweight. Approximately 20.7% had grade 1 hypertension, 50.9% had grade 2, and 18.9% had grade 3, with an average length of hospital stay of 3.53 days.1
Women with obesity had lower concentrations of CRP and TSH levels compared to women without obesity, but HDL levels were significantly lower for women with obesity. Diabetes had a lower prevalence for women with obesity, and Cushing syndrome had a higher prevalence compared with women who did not have obesity. For men, those who were obese had higher TG levels, lower HDL levels, lower rates of Cushing syndrome, but higher diabetes prevalence compared with men without obesity. For hospital stay, investigators found that those who were obese had a 3.4-day hospital stay and underweight individuals had a 5.14-day stay.1
For women, significant predictors of length of hospital stay included LDL, HDL, and hsCRP. Men’s predictors included LDL, HDL, and TC. BMI was not associated with length of hospital stay for either men or women. However, the links between these relevant laboratory tests suggest that pharmaceutical interventions could help to reduce hospital stay if monitored. However, investigators noted that even though some laboratory test results indicated predictability of length of hospital stay, the values were all within normal ranges which could limit applicability.1
