The relationship between neutrophil to lymphocyte ratio and blood pressure variability in hypertensive and normotensive subjecs

OBJECTIVES
Blood pressure (BP) variability is associated with hypertensive (HT) target organ damage and cardiovascular events. The aim of this study was to investigate the relation between neutrophil to lymphocyte ratio (NLR) and BP variabil- ity in hypertensive and normotensive subjects.

STUDY DESIGN
In this cross-sectional study, 150 subjects (63 male, mean age 52.1±5.2 years) were enrolled. In all patients, blood samples and 24-hour ambulatory blood pressure (BP) monitoring were obtained. According to 24-hour ambulatory BP results, participants were divided into four investigation categories. Group 1= Normotensive dipper (ND), Group 2= Normotensive non-dipper (NN), Group 3= HT dipper (HD), Group 4= HT non-dipper (HN).

RESULTS
Highest NLR values were determined in the HN group (p=0.005 vs. ND, p=0.046 vs. NN and p<0.01 vs. HD). NLR values were similar among the ND, NN and HD groups (p>0.05, for all). NLR was correlated with night systolic blood pressure (SBP) (r=0.178, p=0.031), night diastolic blood pressure (DBP) (r=0.176, p=0.032) and BP variation rate (r=- 0.246, p=0.003). Multiple linear regression analysis showed BP variation rate to be an independent predictor of high NLR value (β=0.186, 95% CI=0.918-0.982, p=0.044). In ROC anal- ysis, a level of NLR>2.7 predicted non-dipper HT with 83% sensitivity and 65% specificity (ROC area under curve: 0.653, 95% CI=0.565-0.741, p=0.001).

CONCLUSION
In the present study, we found that NLR levels were significantly correlated with BP variability. The measure- ment of NLR may be used to indicate increased risk of HT- related adverse cardiovascular events.