Body roundness index (BRI) was associated with cardiovascular diseases. But the relationship between BRI with cardiovascular disease (CVD) mortality and all-cause mortality remains largely unknown in hypertensive patients. This prospective cohort study included patients with hypertension who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 through 2018, and aimed to evaluate the association between BRI with CVD mortality and all-cause mortality. A total of 15570 patients were included. Over a median follow-up of 8.0 years (interquartile range, 4.3–12.6 years), 3445 individuals died, including 1166 CVD deaths. Weighted restricted cubic spline regression results showed a nonlinear association between BRI and CVD mortality and all-cause mortality (both P for nonlinear trend <0.001). The weighted multivariate Cox proportional hazards regression showed the hazard ratio (HRs) for CVD mortality were 0.93 (95% CI: 0.84–1.03, P = 0.160) in the low levels of BRI (≤5.9) and 1.11 (95% CI: 1.05–1.19, P < 0.001) in the high levels of BRI (>5.9). Similar associations were observed for all-cause mortality, the HRs were 0.91 (95% CI: 0.87–0.96, P < 0.001) in the low levels of BRI (≤6.3) and 1.09 (95% CI: 1.05–1.13, P < 0.001) in the high levels of BRI (>6.3). This cohort study supported that BRI was nonlinearly associated with CVD mortality and all-cause mortality among patients with hypertension. The thresholds of 5.9 and 6.3 for CVD mortality and all-cause mortality, respectively, may represent intervention targets for lowering the risk of premature death, but this needs to be confirmed in large clinical trials.

身体圆度指数（BRI）与心血管疾病相关。但在高血压患者中，BRI 与心血管疾病 (CVD) 死亡率和全因死亡率之间的关系仍然很大程度上未知。这项前瞻性队列研究纳入了 2001 年至 2018 年参加国家健康和营养检查调查 (NHANES) 的高血压患者，旨在评估 BRI 与 CVD 死亡率和全因死亡率之间的关联。总共纳入了 15570 名患者。在中位随访 8.0 年（四分位距，4.3-12.6 年）中，有 3445 人死亡，其中 1166 人死于 CVD。加权限制三次样条回归结果显示，BRI 和 CVD 死亡率以及全因死亡率之间存在非线性关联（非线性趋势P <0.001）。加权多变量 Cox 比例风险回归显示， 在 BRI 水平较低（≤5.9）时， CVD 死亡率的风险比 (HR) 分别为 0.93（95% CI：0.84-1.03， P = 0.160）和 1.11（95% CI：1.05）。 –1.19，P  < 0.001) 在 BRI 高水平 (>5.9) 中。全因死亡率也观察到类似的相关性， 低水平 BRI（≤6.3）的HR 分别为 0.91（95% CI：0.87-0.96， P < 0.001）和 1.09（95% CI：1.05-1.13， P  < 0.001 ）。 0.001) 在 BRI 高水平 (>6.3) 中。该队列研究支持 BRI 与高血压患者的 CVD 死亡率和全因死亡率呈非线性相关。CVD死亡率和全因死亡率的阈值分别为5.9和6.3，可能代表降低过早死亡风险的干预目标，但这需要在大型临床试验中得到证实。