Association of oxidative balance score with blood pressure, all-cause and cardiovascular disease mortality among hypertensive patients: a prospective study

Objective: The oxidative balance score (OBS) has emerged as a novel marker for assessing oxidative stress status. This study aimed to investigate the association of OBS with systolic blood pressure (SBP), diastolic blood pressure (DBP), all-cause, and cardiovascular disease mortality in hypertensive patients. Methods: We conducted an analysis of data from 7602 hypertensive patients from the National Health and Nutrition Examination Survey (NHANES) 2005–2018. Multiple linear regression, Cox proportional hazards models, Kaplan–Meier survival curves, restricted cubic spline, and subgroup analysis were used to examine the association between OBS and SBP, DBP, estimated pulse wave velocity (ePWV), and mortality risk. Results: The results showed that individuals in the highest OBS quartile (27 ≤ OBS ≤ 40) had a significant 2.41 mmHg reduction in SBP compared to the lowest quartile (5 ≤ OBS ≤ 15) ( P trend < 0.001). Compared to the lowest quartile, individuals in the highest OBS quartile had a 29% lower risk of all-cause mortality and a 44% lower risk of cardiovascular disease mortality ( P trend < 0.001). This inverse association persisted irrespective of antihypertensive medication use. OBS is inversely associated with SBP, all-cause, and cardiovascular disease mortality in hypertensive patients. Conclusion: This finding provides new evidence and suggestions for those with poor blood pressure control and low OBS (<15) to adjust their diet and lifestyle reasonably.