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Association of Inflammatory-Hematological Biomarkers with Hypertension and Related Comorbidities
Evelina Maria Gosav1,2, Daniela Maria Tanase1,2, Anca Ouatu1,2
1Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Insights
Inflammation markers like neutrophils and lymphocytes are linked to hypertension and its complications, including diabetes and kidney disease. These hematological markers show potential but have limited clinical usability due to low specificity.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Endocrinology
Background:
- Arterial hypertension (HTN) is a leading global cause of cardiovascular disease.
- HTN frequently co-occurs with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD).
- A pro-inflammatory state often underlies the interconnectedness of HTN, T2DM, and CKD.
Purpose of the Study:
- To investigate the roles of neutrophils, lymphocytes, and platelets.
- To evaluate the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR).
- To assess these markers in patients with HTN, T2DM, and/or CKD.
Main Methods:
- Retrospective unicentric study of 6077 patients (2018-2023).
- Comparative multivariate analysis after exclusion criteria application.
- Statistical analysis including Mann-Whitney U and Kruskal-Wallis tests, and Receiver Operating Characteristic (ROC) analysis.
Main Results:
- Higher neutrophils, lower lymphocytes, and fluctuating platelets associated with HTN + comorbidities (p < 0.001).
- ROC analysis indicated significant associations for neutrophils, lymphocytes, NLR, and PLR in various HTN subgroups.
- AUC specificities were generally below acceptable thresholds, limiting practical clinical utility.
Conclusions:
- Hematological pro-inflammatory markers are associated with hypertension and its comorbidities.
- Neutrophils, lymphocytes, NLR, and PLR show potential as indicators in HTN, T2DM, and CKD.
- Further research is needed to enhance the clinical applicability of these inflammatory markers.
Abstract:
Background: According to current data, arterial hypertension (HTN) remains the leading cause of cardiovascular disease worldwide. Oftentimes, HTN is accompanied by type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD), interconnected by a pro-inflammatory pattern. Our study aimed to evaluate the roles of hematological serum cells, such as neutrophils, lymphocytes, and platelets, as well as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in subjects with HTN, CKD, and/or T2DM. Methods: This retrospective unicentric study included 6077 patients admitted between 2018 and 2023; after applying exclusion criteria, patients were divided into groups for a comparative multivariate analysis. Results: The Mann-Whitney U test and the Kruskal-Wallis test showed statistically significant differences between groups. Higher neutrophil counts, lower lymphocyte counts, and platelet fluctuations were positively associated with HTN + comorbidities (p < 0.001 **). Receiver operating characteristic (ROC) analysis identified statistically significant associations for neutrophils and NLR in HTN (AUC = 0.442, p < 0.001 **, cut-off = 1.1217), for lymphocytes in HTN + T2DM (AUC sensitivity of 64.1%, cut-off = 18.950), for NLR (AUC 0.567, sensitivity of 50.6% and a specificity of 61.9% cut-off = 4.4174) and neutrophils (cut-off = 73.550) in HTN + CKD, and for NLR and PLR in HTN + CKD + T2DM (both having reliable AUC; sensitivity 87.9% and 81.8% for cut-off = 2.6957 and 10.5194, respectively). In all groups, AUC specificities were below the acceptable threshold (which considerably diminishes the practical clinical usability potential of these markers). Conclusions: This study demonstrated an association between hematological pro-inflammatory markers and hypertension and its comorbidities.
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