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The relationship between red blood cell distribution width and blood pressure abnormal dipping in patients with
1Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
Insights
Red blood cell distribution width (RDW) was higher in hypertensive patients with reverse-dipper blood pressure patterns. Elevated RDW may indicate abnormal blood pressure dipping, suggesting a potential biomarker for hypertension management.
Area of Science:
- Cardiology
- Hematology
- Clinical Hypertension Research
Background:
- Hypertension management involves understanding circadian blood pressure (BP) patterns.
- The reverse-dipper pattern, characterized by elevated nocturnal BP, is associated with increased cardiovascular risk.
- Red blood cell distribution width (RDW) is a measure of red blood cell size variation and has been linked to various cardiovascular conditions.
Purpose of the Study:
- To investigate the association between red blood cell distribution width (RDW) and the reverse-dipper blood pressure (BP) pattern in patients with essential hypertension.
- To explore RDW as a potential indicator for abnormal circadian BP variations.
Main Methods:
- A cross-sectional study involving 708 patients with essential hypertension.
- 24-hour ambulatory blood pressure monitoring (ABPM) was used to classify BP dipping patterns.
- Red blood cell distribution width (RDW) was measured using an automated haematology analyser.
- Analysis of variance (ANOVA) and multinomial logistic regression were employed for statistical analysis.
Main Results:
- Patients with the reverse-dipper BP pattern exhibited significantly higher RDW compared to dippers (p=0.012).
- RDW was independently associated with the reverse-dipper BP pattern (OR 1.325, p=0.024), alongside diabetes mellitus.
- RDW showed a negative correlation with the nocturnal systolic and diastolic BP decline rate (p=0.003 and p=0.007, respectively).
Conclusions:
- Red blood cell distribution width (RDW) is associated with abnormal blood pressure dipping patterns, specifically reverse dipping in hypertensive patients.
- RDW may serve as a potential biomarker for identifying patients with abnormal circadian blood pressure regulation.
- Further research is warranted to elucidate the clinical implications of RDW in hypertension management.
Objective:
To investigate whether red blood cell distribution width (RDW) is associated with the blood pressure (BP) reverse-dipper pattern in patients with hypertension.
Design:
Cross-sectional study.
Setting:
Single centre.
Participants:
Patients with essential hypertension were included in our study (n=708). The exclusion criteria included age <18 or >90 years, incomplete clinical data, night workers, diagnosis of secondary hypertension, under antihypertensive treatment, intolerance for the 24 h ambulatory BP monitoring (ABPM) and BP reading success rate <70%.
Measurement:
Physical examination and ABPM were performed for all patients in our study. The value of RDW was measured using an automated haematology analyser.
Statistical Methods:
The distribution of RDW in patients with hypertension among different circadian BP pattern groups was analyzed using analysis of variance (ANOVA). Multinomial logistic regression was applied to explore the associations of RDW and other relevant variables with ABPM results.
Results:
There was significantly increased RDW in reverse dippers (13.52 ± 1.05) than dippers (13.25 ± 0.85) of hypertension (p=0.012). Moreover, multinomial logistic regression analysis showed that RDW (OR 1.325, 95% CI 1.037 to 1.692, p=0.024) and diabetes mellitus (OR 2.286, 95% CI 1.380 to 3.788, p=0.001) were significantly different when comparing the reverse-dipper BP pattern with the dipper pattern. However, there was no difference of RDW between the non-dipper pattern and the reverse-dipper pattern (OR 1.036, 95% CI 0.867 to 1.238, p=0.693). In addition to this, RDW was negatively correlated with the decline rate of nocturnal systolic BP (r=-0.113; p=0.003) and diastolic BP (r=-0.101; p=0.007).
Conclusions:
Our results suggested that RDW might associate with the abnormal dipper BP patterns of either reverse dipping or non-dipping homogeneously examined with 24 h ABPM.
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