Affiliation:
1. Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa
2. Department of Cardiology, Gazi Yaşargil Training and Research Hospital, Diyarbakir
3. Department of Cardiology,Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul
4. Nursing Department, Şanliurfa Provincial Health Directorate, Sanliurfa, Turkey
Abstract
Objective
Physiologically, at night, blood pressure (BP) is expected to decrease by at least 10% in hypertensive individuals. The absence of this decrease, called non-dipper hypertension, is associated with increased end-organ damage and cardiovascular mortality and morbidity in hypertensive individuals. It is known that increased inflammatory process plays an important role in the etiopathogenesis of non-dipper hypertension pattern. In recent years, it has been shown that inflammation-based markers (IBMs) obtained by combining various inflammation-related hematological and biochemical parameters in a single fraction have stronger predictive value than single inflammatory parameters. However, until now, there has not been a study investigating the relationship of these markers with dipper/non-dipper status in newly diagnosed hypertensive patients.
Methods
Based on ambulatory BP monitoring, 217 dipper and 301 non-dipper naive hypertensive subjects were included in this study. All subjects’ IBM values were compared between dipper and non-dipper hypertensive individuals.
Results
IBMs [C-reactive protein/albumin ratio (CAR), monocyte/high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, systemic immune-inflammation index (SII), uric acid/albumin ratio (UAR)] were significantly higher in the non-dipper group. CAR, MHR, NLR, SII, and UAR were determined as independent predictors for non-dipper pattern (P < 0.05, for all). Also, UAR’s diagnostic performance for non-dipper pattern was found to be superior to other IBMs (area under the curve: 0.783, 95% confidence interval: 0.743–0.822; P < 0.001).
Conclusion
These findings suggest an association between elevated IBMs, particularly UAR, and the non-dipper hypertension pattern observed in our study.
Publisher
Ovid Technologies (Wolters Kluwer Health)