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Could the Systemic Inflammatory Response Index be a Marker for the Non-Dipper Pattern in Newly Diagnosed Hypertensive
Mustafa Kaplangoray1, Kenan Toprak2, Cuneyt Caglayan3
1Cardiology Department, Acıbadem Eskişehir Hospital, Eskişehir, Turkey. mkaplangoray@gmail.com.
Insights
The Systemic Inflammatory Response Index (SIRI) can predict non-dipper hypertension (NDHT). Higher SIRI levels were found in non-dipper hypertensive patients, indicating its potential as a diagnostic marker.
Area of Science:
- Cardiology
- Immunology
- Hypertension Research
Background:
- The Systemic Inflammatory Response Index (SIRI) is linked to outcomes in cardiovascular diseases like coronary artery disease and heart failure.
- Non-dipper hypertension (NDHT), a pattern of abnormal blood pressure dipping, is associated with increased cardiovascular risk.
- Investigating novel biomarkers for identifying NDHT is crucial for risk stratification and management.
Purpose of the Study:
- To evaluate the association between the Systemic Inflammatory Response Index (SIRI) and non-dipper hypertension (NDHT) in newly diagnosed hypertensive patients.
- To determine if SIRI can serve as an independent predictor for NDHT.
- To compare the diagnostic performance of SIRI against other inflammatory and cardiovascular risk markers for NDHT.
Main Methods:
- A retrospective study of 254 newly diagnosed hypertensive patients who underwent ambulatory blood pressure monitoring (ABPM).
- Patients were categorized into dipper (DHT) and non-dipper (NDHT) groups.
- SIRI was calculated using neutrophil, monocyte, and lymphocyte counts. Other markers included MHR, NLR, PLR, CRP, HDL-C, and LVMI.
Main Results:
- The NDHT group exhibited significantly higher SIRI, MHR, NLR, PLR, CRP, and neutrophil counts compared to the DHT group.
- Conversely, HDL-C and lymphocyte counts were lower in the NDHT group.
- Multivariate analysis identified SIRI, LVMI, and HDL-C as independent predictors of NDHT. SIRI demonstrated superior discriminative capacity for predicting NDHT compared to other indices.
Conclusions:
- SIRI is an independent and significant predictor of non-dipper hypertension.
- The Systemic Inflammatory Response Index shows superior diagnostic performance for identifying NDHT compared to MHR, NLR, PLR, HDL-C, and LVMI.
- SIRI may serve as a valuable, easily accessible biomarker for detecting NDHT in clinical practice.
Abstract:
Systemic inflammatory response index (SIRI), is associated with prognosis in coronary artery disease (CAD), heart failure (HF), and acute myocardial infarction. This study investigated the relationship between SIRI and non-dipper hypertension. The study retrospectively included a total of 254 naive, newly diagnosed hypertensive individuals based on ambulatory blood pressure monitoring (ABPM), containing 166 dippers (DHT) and 88 non-dippers (NDHT). The SIRI value of all patients was calculated based on neutrophil, monocyte, and lymphocyte counts. The average age of study population was 50.7 ± 9.4 years old, and the male ratio was 68.5%. Compared with DHT, patients in the NDHT group had higher SIRI, monocyte to HDL-C ratio (MHR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), and neutrophil count, while high-density lipoprotein cholesterol (HDL-C) and lymphocyte count were lower (p < 0.05). The left ventricular mass index (LVMI) was higher in the NDHT group (p < 0.05). Multivariate logistic regression analysis showed that SIRI, LVMI, and HDL-C were independent predictor factors for NDHT. ROC curve analysis determined the optimal SIRI cut-off value for predicting NDHT diagnosis to be 2.41 (sensitivity 69.3%, specificity 64.5%, area under the receiver operating characteristic curve, 0.743; p < 0.001). The AUC values obtained for SIRI, MHR, NLR, PLR, HDL-C, and LVMI parameters in the ROC curve analysis were compared pairwise. The results demonstrated that SIRI's discriminative capacity in predicting NDHT was superior to all other indices. SIRI is an independent and significant predictor factor for NDHT and is superior in predicting NDHT diagnosis compared with HDL-C, MHR, LVMI, NLR, and PLR.
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