Akyüz Abdurrahman, Işık Ferhat
Department of Cardiology, University of Health Sciences Gazi Yaşargil Training and Research Hospital, Diyarbakır, TUR.
Cureus. 2022 Aug 19;14(8):e28176. doi: 10.7759/cureus.28176. eCollection 2022 Aug.
Introduction The non-dipper hypertension (HT) pattern is associated with more end-organ damage and cardiovascular events than is dipper HT. Inflammation is widely established to play a role in the pathophysiology of HT. Recently, a new inflammatory and prognostic marker called the systemic immune-inflammation index (SII) has emerged. Our goal is to determine whether there is a relationship between non-dipper HT and SII. Methods Our study is a single-center retrospective and ninety-one patients with HT were included. All patients were analyzed with simultaneous 24-hour ambulatory blood pressure monitoring and laboratory parameters. Thirty-five patients had dipper HT while 56 patients had non-dipper HT. SII was calculated according to neutrophil, platelet, and lymphocyte counts. Results The median age was 48 (45-61 interquartile range (IQR)) in the non-dipper HT group, whereas it was 54 (44-64 IQR) in the dipper HT group. Although the neutrophil level, neutrophil-lymphocyte ratio, platelet lymphocyte ratio, SII, sleeping systolic blood pressure (BP), and sleeping diastolic BP were higher (p=0.020, p=0.041, p=0.046, p=0.019, p<0.001, and p=0.001, respectively) in the non-dipper HT group, the lymphocyte level was lower (p=0.040). A multivariate logistic regression model shows that SII (odds ratio (OR)=1.023, 95% confidence interval (CI)=1.002-1.112, p=0.012) may be an independent predictor of non-dipper HT. Conclusion Our study showed that the SII level was higher in the non-dipper HT patient group than in the dipper HT group. Furthermore, SII was an independent predictor of non-dipper HT. The high SII value in hypertension patients can be used as an early warning parameter to identify non-dipper HT patients.
引言 与杓型高血压相比，非杓型高血压模式与更多的靶器官损害和心血管事件相关。炎症在高血压的病理生理学中发挥作用已得到广泛证实。最近，一种名为全身免疫炎症指数（SII）的新的炎症和预后标志物出现了。我们的目标是确定非杓型高血压与SII之间是否存在关联。方法 我们的研究是一项单中心回顾性研究，纳入了91例高血压患者。所有患者均同时进行24小时动态血压监测和实验室参数分析。35例患者为杓型高血压，56例患者为非杓型高血压。根据中性粒细胞、血小板和淋巴细胞计数计算SII。结果 非杓型高血压组的中位年龄为48岁（四分位间距（IQR）为45 - 61岁），而杓型高血压组为54岁（IQR为44 - 64岁）。尽管非杓型高血压组的中性粒细胞水平、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、SII、睡眠收缩压和睡眠舒张压较高（分别为p = 0.020、p = 0.041、p = 0.046、p = 0.019、p < 0.001和p = 0.001），但淋巴细胞水平较低（p = 0.040）。多因素逻辑回归模型显示，SII（比值比（OR）= 1.023，95%置信区间（CI）= 1.002 - 1.112，p = 0.012）可能是非杓型高血压的独立预测因子。结论 我们的研究表明，非杓型高血压患者组的SII水平高于杓型高血压组。此外，SII是非杓型高血压的独立预测因子。高血压患者的高SII值可作为识别非杓型高血压患者的早期预警参数。
