Subclinical inflammation and paediatric hypertension: the diagnostic value of haematological markers

Systemic inflammation plays an important role in the pathophysiology of hypertension, contributing to endothelial dysfunction and target organ damage. This study aimed to evaluate the diagnostic and predictive value of the systemic immune inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and C-reactive protein-albumin ratio in children with primary hypertension by comparing them with healthy controls, assessing their association with disease severity, and examining changes after treatment.

This retrospective study included 49 paediatric patients with newly diagnosed primary hypertension and 50 age- and gender-matched healthy controls. Complete blood count derived indices and biochemical markers were analysed. Patients were stratified by hypertension stage, and post-treatment changes in inflammatory indices were evaluated.

The mean age was 16.3 ± 1.9 years in the hypertension group and 15.8 ± 1.3 years in the control group. Systemic immune inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and C-reactive protein-albumin ratio were significantly higher in children with hypertension than in controls (p < 0.05). Systemic immune inflammation index was markedly higher in stage 2 compared with stage 1 hypertension (p = 0.003) and decreased significantly after treatment (p < 0.001). Neutrophil-to-lymphocyte ratio and C-reactive protein-albumin ratio emerged as strong diagnostic markers, while systemic immune inflammation index, although less discriminative, was associated with disease severity and decreased significantly after treatment.

Neutrophil-to-lymphocyte ratio and C-reactive protein-albumin ratio provide robust diagnostic value in paediatric hypertension. Systemic immune-inflammation index, despite modest diagnostic accuracy, has prognostic significance by indicating disease severity and monitoring treatment effects. Collectively, these markers may serve as cheap and accessible tools for early diagnosis, risk stratification, and follow-up in children with hypertension.