The association between hypertension and neutrophil to lymphocyte ratio in patients with obstructive sleep apnea syndrome

Abstract

Introduction: Obstructive sleep apnea syndrome (OSAS) is associated with low-grade inflammation. Neutrophil to lymphocyte ratio (NLR) represents a newly introduced, low-cost and practical marker of inflammation. Increased incidence of comorbidities in relation to inflammation has been reported in OSAS patients. Also, hypertension (HT) occurs more commonly in patients with OSAS. Aim: Our aim was to examine the association between NLR and HT in OSAS in order to determine the potential role of NLR in predicting comorbidities such as HT in OSAS. Methods: A total of 232 patients with a poly-somnography based diagnosis of obstructive sleep apnea (OSAS) established within the past 2-year period in our hospital were included in this study. The patients were defined on the basis of the presence or absence of HT. Patients with or without HT were compared in terms of NLR and other laboratory parameters. Results: OSAS patients without HT had an average CRP of 0.57 ± 1.06, while it was 1.02 ± 2.04 among those with HT, with a statistically significant difference between the two groups (p=0.05). Also, there was a statistically significant difference in ESR values in OSAS patiens with (21.55 ± 19.73) or without (9.77 ± 10.99) HT (p=0.008). Again, a significant difference in NLR between OSAS patients with (3.59 ± 14.92) or without (1.72 ± 0.69) HT was found (p=0.014). Conclusions: A positive correlation between elevated NLR and HT was found as well as between elevated NLR and other inflammatory markers such as CRP and sedimentation rate. A high NLR may represent a low-cost and practical marker for predicting comorbidities in patients with OSAS.