Ibrahim Olayinka Rasheed, Hutton-Mensah Kojo Awotwi, Adeniyi Funmi Temidayo, Nketiah George Bediako, Nwankwo Adaku M, Natogmah Abukari Yakubu, Ogunmodede James Ayodele, Ojji Dike, Olumide Adesola, Alabi Biodun Sulyman, Sarpong Daniel F, Mokuolu Olugbenga Ayodeji
Department of Pediatrics, Division of Clinical Medicine, University of Global Health Equity, Kigali, Rwanda.
Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
J Hum Hypertens. 2025 Feb;39(2):171-176. doi: 10.1038/s41371-025-00987-w. Epub 2025 Jan 11.
Red cell distribution width (RDW) quantifies the degree of variation in erythrocyte size, is identified as a potential marker of adverse cardiovascular events, and may be a surrogate marker for assessing cardiovascular disease (CVD) risk in low-resource settings. We evaluated RDW as a predictor of CVD risk compared to the World Health Organization (WHO) CVD risk score among adults with hypertension attending primary healthcare centers (PHCs) in Ghana and Nigeria. Adults with hypertension attending selected PHCs in Ghana and Nigeria participated in a cross-sectional study. Each participant underwent blood pressure (BP) measurement and laboratory evaluation (RDW, total cholesterol, and fasting blood sugar) following standard methods. We recruited 319 adults aged 40-74 years from the study sites. The mean (standard deviation) RDW was 13.96 (1.1%). The median CVD risk score was 8.11% [interquartile range (IQR) 4.00 to 11.00]. For participants with hemoglobin (Hb) levels ≥ 12 g/dL, RDW showed positive correlations with age (r = 0.136; p = 0.042); systolic BP (r = 0.183; p = 0.006), diastolic BP (r = 0.206, p = 0.002) and WHO CVD risk scores (r = 0.166, p = 0.013). Multiple linear regression showed an independent association between RDW and WHO CVD risk scores with an upward gradient, and was most significant at 3rd quartiles. Using receiver operating characteristic curve, the C-statistic was 0.673 (95% confidence interval: 0.618 to 0.724), p = 0.031. With a cut-off of >14, the RDW demonstrated a sensitivity of 81.82% and specificity of 55.84%. This study shows that at Hb levels ≥ 12 g/dL, RDW modestly predicted CVD risk in adults with hypertension in sub-Saharan Africa.
红细胞分布宽度（RDW）可量化红细胞大小的变异程度，被视为不良心血管事件的潜在标志物，并且在资源匮乏地区可能是评估心血管疾病（CVD）风险的替代标志物。我们在加纳和尼日利亚的初级医疗保健中心（PHC）就诊的高血压成人中，将RDW作为CVD风险预测指标与世界卫生组织（WHO）的CVD风险评分进行了比较。在加纳和尼日利亚选定的PHC就诊的高血压成人参与了一项横断面研究。每位参与者按照标准方法进行血压（BP）测量和实验室评估（RDW、总胆固醇和空腹血糖）。我们从研究地点招募了319名年龄在40 - 74岁的成年人。平均（标准差）RDW为13.96（1.1%）。CVD风险评分中位数为8.11%[四分位间距（IQR）4.00至11.00]。对于血红蛋白（Hb）水平≥12 g/dL的参与者，RDW与年龄呈正相关（r = 0.136；p = 0.042）；与收缩压（r = 0.183；p = 0.006）、舒张压（r = 0.206，p = 0.002）以及WHO CVD风险评分呈正相关（r = 0.166，p = 0.013）。多元线性回归显示RDW与WHO CVD风险评分之间存在独立关联，呈上升梯度，并且在第三四分位数时最为显著。使用受试者工作特征曲线，C统计量为0.673（95%置信区间：0.618至0.724），p = 0.031。截断值>14时，RDW的灵敏度为81.82%，特异度为55.84%。这项研究表明，在Hb水平≥12 g/dL时，RDW适度预测了撒哈拉以南非洲高血压成人的CVD风险。
