BackgroundEmerging evidence suggests that the neutrophil/lymphocyte ratio (NLR) may be a useful marker of cardiovascular disease and a more powerful predictor than any other leukocyte subtypes. We determined whether NLR is related to atherosclerosis measured by brachial–ankle pulse wave velocity (baPWV) and coronary calcium score (CCS). MethodsWe examined the relationship of NLR with baPWV and CCS in 849 Korean adults in a health examination program. The odds ratios for a high baPWV or a high CCS were calculated using multivariate logistic regression analysis across NLR quartiles. A high baPWV was defined as >1500cm/s (>75th percentile) and a high CCS was defined as over 100 (at least moderate atherosclerotic plaque burden). ResultsThe ORs (95% CIs) for a high baPWV by NLR quartiles were 1.00, 0.76 (0.41–1.39), 1.08 (0.61–1.90), and 2.12 (1.18–3.83) after adjusting for confounding variables.Similarly, positive associations between NLR and a high CCS were also observed after adjusting for the same co-variables. ConclusionA higher NLR was independently associated with arterial stiffness and CCS. Accordingly, a higher NLR may be a useful additional measure in assessing cardiovascular risks in clinical practice.