Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey.
J Clin Hypertens (Greenwich). 2023 Aug;25(8):700-707. doi: 10.1111/jch.14688. Epub 2023 Jul 18.
Although hypertension is considered high intravascular pressure, impairing circadian blood pressure (BP) has been shown to potentially contribute to poor clinical outcomes. Systemic immune-inflammation index (SII), based on platelet, neutrophil, and lymphocyte counts, has been established as a strong prognostic marker in cardiovascular disease. The role of inflammation in the pathogenesis of hypertension is a well-known issue and inflammatory markers are associated with BP variability. We aimed to investigate whether there is a relationship between circadian BP changes and SII in newly diagnosed hypertensive patients. The study population consisted of 196 newly diagnosed hypertensive patients without LVH. In total, 76 (38%) patients had a dipper BP pattern, 60 (31%) patients had a non-dipper BP pattern, and 60 (31%) patients had a reverse-dipper BP pattern. SII was calculated according to Multivariate logistic regression analysis revealed SII and HDL-C as an independent predictors of reverse-dipper circadian pattern in newly diagnosed hypertensive patients. The cut-off value of the SII for reverse-dipper hypertension in a ROC curve analysis was >639.73 with 63.3% sensitivity and 84.2% specificity. Our study showed that the SII level was higher in the reverse-dipper hypertension patient group than in the dipper and non-dipper hypertension groups. Furthermore, SII was an independent predictor of newly diagnosed reverse-dipper hypertensive patients. The high SII value in newly diagnosed hypertensive patients can be used as an early warning parameter to identify reverse-dipper hypertension patients.
虽然高血压被认为是高血管内压，但已表明损害昼夜血压（BP）可能导致不良临床结局。基于血小板、中性粒细胞和淋巴细胞计数的全身免疫炎症指数（SII）已被确立为心血管疾病的强有力预后标志物。炎症在高血压发病机制中的作用是一个众所周知的问题，炎症标志物与 BP 变异性相关。我们旨在研究新诊断的高血压患者中昼夜血压变化与 SII 之间是否存在关系。研究人群包括 196 名无左室肥厚的新诊断高血压患者。共有 76 名（38%）患者存在杓型血压模式，60 名（31%）患者存在非杓型血压模式，60 名（31%）患者存在反杓型血压模式。根据多元逻辑回归分析计算 SII，结果显示 SII 和 HDL-C 是新诊断高血压患者反杓型昼夜模式的独立预测因子。ROC 曲线分析中 SII 对反杓型高血压的截断值为>639.73，敏感性为 63.3%，特异性为 84.2%。我们的研究表明，反杓型高血压患者组的 SII 水平高于杓型和非杓型高血压患者组。此外，SII 是新诊断反杓型高血压患者的独立预测因子。新诊断高血压患者中 SII 值较高可用作识别反杓型高血压患者的早期预警参数。
