NEUTROPHIL TO LYMPHOCYTE RATIO AND PLATELET TO LYMPHOCYTE RATIO ARE INDEPENDENT PREDICTORS FOR BLOOD PRESSURE VARIABILITY

Abstract

Objective: Hypertension is a major risk factor for cardiovascular diseases. Ambulatory blood pressure monitoring is used for detection, follow-up of hypertensive patients and also demonstrates the diurnal variability of the blood pressure. Decreased blood pressure variability is associated with hypertensive target organ damage and higher risk for cardiovascular events. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are also related to inflammation and increased cardiovascular risk. The purpose of the study is to investigate the relationship between NLR and PLR with non-dipper status of hypertensive and normotensive patients.Design and method: A total of 482 patients were evaluated retrospectively. Patients with previous hypertension diagnosis, acute coronary syndrome, serious valve regurgitation or stenosis, coronary artery disease, echocardiographic findings of reduced left ventricular ejection fraction (LVEF < 55%), congenital heart diseases, abnormal kidney function, chronic liver disorders, chronic inflammatory disease, patients who had a recent history of acute infection were excluded. Results: Mean age of the study population was 50.1 ± 15.5 years, 38.1% were male. Four groups were formed according to hypertension diagnosis, dipper and non-dipper patterns. Group 1 was consisted of 165 patients with hypertensive and non-dipper status; group 2 was consisted of 88 patients with hypertensive and dipper status; group 3 was consisted of 123 patients with normotensive and non-dipper status; and group 4 was consisted of 91 patients with normotensive and dipper status. Neutrophil lymphocyte ratio was statistically different among groups (p = 0.000). Group 1 had significantly higher values compared to Group 2 (p = 0.001), Group 3 (0.002) and Group 4 (p = 0.023). In hypertensive patient group, PLR values of Group 1 was significantly higher than Group 2 (p = 0.002). Pearson correlation analysis showed that NLR and PLR were correlated with BP variability between night and day (r = -0.188, p = 0.000 for NLR and r = -0.182 and p = 0.000 for PLR). Regression analysis showed NLR (p = 0.040), PLR (p = 0.021), age (p = 0.006) and hypertension (p = 0.000) were independent predictors of BP variability. Conclusions: In conclusion NLR and PLR can be used as easily accessible and inexpensive markers for non-dipper status especially in hypertensive patients.