The Geriatric Nutritional Risk Index (GNRI) is a simple and effective prognostic evaluation tool that can rapidly assess the nutritional status of elderly individuals. In recent years, numerous studies have confirmed that GNRI has important value in predicting the prognosis of patients with various diseases, including hemodialysis, cancer, heart failure, and chronic obstructive pulmonary disease. Several long‑term studies have also shown that GNRI is associated with the risk of renal events, cardiovascular events, and all‑cause mortality in hypertensive patients. However, studies on the correlation between GNRI and blood pressure remain scarce.
Against this background, a study from Shanghai, China, used GNRI to evaluate the nutritional status of elderly hypertensive patients and investigated the correlation between GNRI and ambulatory blood pressure.
A total of 626 elderly hypertensive patients were enrolled in this study, including 341 males (54%), with a mean age of 70.5 years. The proportion of patients with malnutrition was 37% (235 cases).
Compared with the normal nutrition group (391 cases), the malnutrition group had an older age (mean difference 1.7 years, P < 0.001), higher serum creatinine (mean difference 13.9 μmol/L, P < 0.001), lower body weight (mean difference 1.9 kg, P < 0.05), lower estimated glomerular filtration rate, and lower serum low‑density lipoprotein cholesterol. There were no statistically significant differences between the two groups in gender distribution, height, duration of hypertension, heart rate, serum triglycerides, total cholesterol, high‑density lipoprotein cholesterol, prevalence of diabetes, current smoking rate, alcohol consumption rate, or use of various antihypertensive drugs (P > 0.1).
GNRI is a convenient and accurate indicator for nutritional assessment. It includes serum albumin and body mass index, both of which are objective measurements. Clinicians can systematically use GNRI to identify patients suitable for nutritional support. Malnutrition among the elderly remains highly prevalent in developing countries. In this study, the prevalence of malnutrition in elderly hypertensive patients reached 37%, most of whom had mild malnutrition. Such patients are at nutritional risk and may benefit from nutritional supplementation interventions.
This study confirmed that GNRI was significantly correlated with systolic blood pressure. Although previous studies have shown that GNRI is associated with the risk of adverse outcomes in hypertensive patients, research on the relationship between malnutrition and blood pressure remains limited.
To date, no study has explored the association between nutritional status assessed by GNRI and blood pressure in elderly hypertensive patients. This study is the first to demonstrate that reduced GNRI is significantly associated with elevated systolic blood pressure and may directly affect the prognosis of hypertensive patients.
GNRI is significantly correlated with systolic blood pressure in elderly hypertensive patients. It is well known that overnutrition causes metabolic disorders and thus induces hypertension. Therefore, a reasonable diet structure and balanced nutritional intake are essential for the prevention and control of hypertension. Hypertension management requires not only sodium restriction but also optimized nutrition through increased intake of potassium, calcium, magnesium, high‑quality protein, and multiple vitamins. GNRI should be used routinely in clinical practice to assess the nutritional status of the elderly, especially elderly patients with chronic diseases.