Abstract

Background and Objectives: The relationship between serum albumin and hypertension has attracted much attention. We sought to further validate these findings and explore the underlying mediators. Methods and Study Design: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES 1999-2004), including 19,507 participants. Multivariable weighted logistic were employed to investigate the association of serum albumin with hypertension. The potential mediating role of body mass index (BMI), C-reactive protein (CRP), and extracellular fluid (ECF) was explored. Secondary analyses included subgroup analyses and restricted cubic spline (RCS). Results: Serum albumin per 1 g/L increase was associated with 10% lower hypertension prevalence (OR=0.90, 95%CI:0.89–0.91, p<0.001). This remained significant after full adjustment (including age, sex, race/ethnicity, education level, smoking status, drinking status, sodium intake, potassium intake, fat intake, total saturated fatty acids [TSFA] intake, carbohydrate intake, protein intake, energy intake, diabetes, coronary heart disease, creatinine, alanine aminotransferase [ALT], and NHANES cycle)(OR = 0.98, 95%CI: 0.96–1.00, p = 0.031). No evidence of non-linearity was observed in the RCS analysis (p for non-linearity = 0.708). BMI mediated 42.75% (95%CI: 38.19%–48.33%), CRP 12.24% (95%CI: 9.29%–15.43%), and ECF 4.05% (95%CI: 2.74%–5.43%) of the association (all p <0.001). Results were robust in sensitivity analyses. Conclusions: The serum albumin levels were negatively associated with the prevalence of hypertension. Mediation analyses demonstrated a significant mediating effect of BMI, CRP and ECF, suggesting that serum albumin might be related to hypertension, potentially mediated by BMI, ECF, and CRP.

Download this article

PDF format

Supplementary files

Supplementary materials