Abstract
Aim: Hypertension is associated with cardiac structural and functional changes, including left ventricular hypertrophy (LVH) and LV systolic dysfunction diastolic dysfunction. Neutrophil-to-lymphocyte ratio (NLR) is a novel inflammatory biomarker associated with cardiovascular diseases. The current study aimed to evaluate NLR in children with newly diagnosed essential hypertension and its relationship between blood pressure and cardiac changes.Methods and Subjects: Sixty-five children with newly diagnosed essential hypertension and 54 healthy children were included. Clinical characteristics, blood cell counts, and biochemical parameters were collected. LVH was assessed by calculation of LV mass index (LVMI), and LV systolic function was evaluated by measuring LV ejection fraction and fractional shortening. LV diastolic function was primarily assessed with E/E′ ratio by Doppler and echocardiography.Results: The hypertension children had significantly higher LVMI and E/E′ ratio than the controls, whereas there was no difference in LV systolic function between the two groups. The NLR was significantly higher in the hypertension group than the control group. Moreover, NLR was positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels in the hypertension group. Additionally, a significantly positive correlation between NLR and E/E′ ratio was found in the hypertension group. However, NLR was not related to LVH and LV systolic function indicators in hypertension children.Conclusion: NLR is elevated in hypertension children, and it is associated positively with office blood pressure levels. Moreover, NLR may help assess LV diastolic function in hypertension children.
Highlights
Hypertension is the leading risk factor for cardiovascular disease and mortality in adults, with a prevalence of 31.1% worldwide [1]
Our study demonstrated the elevation of LVM index (LVMI) and the reduction of diastolic function in newly diagnosed essential hypertension children
We found that left ventricular mass (LVM) and LVMI were both higher in hypertension children, and among 65 hypertension adolescents, 12.31% (8/65) had LV hypertrophy (LVH)
Summary
Hypertension is the leading risk factor for cardiovascular disease and mortality in adults, with a prevalence of 31.1% worldwide [1]. In parallel with the growing prevalence of childhood obesity, it is becoming an increasing problem among children over the last few decades, as a consequence of obese children who are at approximately a three-fold higher risk for hypertension than non-obese children [2]. Growing evidence shows that hypertension results in target organ damage, even in prehypertension children [6]. The increased left ventricular mass (LVM) and cardiac function abnormalities are the early change in target organ damage [7]. Screening for rapid and straightforward indicators to reflect the target organ damage has become a useful strategy in managing childhood hypertension
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