The relationship between complete blood count derived inflammatory biomarkers and ambulatory blood pressure variability

Introduction: Inflammation as a promoter of systemic inflammation and its role in the onset and progression of atherosclerosis is a topic of great relevance. In the age of the biomarkers, costly and unnecessary determi-nations are frequent. At the same time, new inflamma-tory markers are not widely available and expensive. It has been observed that hypertension is associated with abnormalities of the erythrocyte series by increasing the level of red blood cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR). Blood pressu-re variability (BPV) seems to be a surrogate risk factor in hypertension.

Objective: To test the relationship between BPV and these „non-specific“ markers of inflammation. Methods: A number of 53 treated hypertensive patients were included, 33.9% women, 66.03% men, mean age was: 67.33 ± 10.83 years. Exclusion criteria were any inflammatory disease that alters the leukocyte formula, diabetes mellitus, coronary artery disease, peripheral artery disease, documented kidney disease. From the complete blood count (CBC) neutrophil-lymphocyte percentage ratio and red cell distribution width (RDW) were calculated. Based on 24 hour ambulatory BP mo-nitoring (ABPM), blood pressure variability was calcu-lated by the average real variability (ARV). Using the median of this value, the subjects were divided into low and high variability groups. The inflammatory status of the groups, the correlation between biomarkers of in-flammation and BPV were analyzed.

Results: The median ARV was 10.89 mmHg, the ne-utrophil-lymphocyte ratio in the low versus increased variability group was 2.83 ± 0.14 vs. 2.32 ± 0.2, p=0.04, and the RDW was 13.2 ± 0.34% vs. 12.52 ± 0.20% in the high variability group, p=0.03. We found positive correlation between RDW and BP variability, p=0.00, r2=0.19, CI: 0.1220-0.6009. The correlation between neutrophil-lymphocyte ratio and ARV was statistically less significant, p=0.05, r2=0.07, CI: 0.01101-0.5087.

Conclusions: Increased blood pressure variability appears to be associated with more pronounced in-flammatory status. The neutrophil-lymphocyte ratio and red cell distribution width as parts of the routine investigations are cost-effective and could be useful for screening of patients with high cardiovascular risk for specific investigations

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
ESC search engine
CODE: 379
CME Credits: 10 (Romanian College of Physicians)