Can neutrophil to lymphocyte ratio and platelet to lymphocyte ratio be used as biomarkers for non-dipper blood pressure?

Abstract

Aim: Hypertension is a major risk factor for cardiovascular diseases and non-dipper status is associated with increased risk for cardiovascular events. Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are related to inflammation and cardiovascular risk. The purpose of the study is to investigate the relationship between NLR and PLR with non-dipper status of hypertensive and normotensive patients.  Methods:  A total of 482 patients were enrolled for the study. The study was planned as retrospective cohort study. Four groups were formed according to 24-h ambulatory blood pressure monitoring results. Group 1 was defined as hypertensive, non-dipper patients; group 2 as hypertensive, dipper patients; group 3 as normotensive, non-dipper patients and group 4 as normotensive, dipper patients.Results: Mean age of the study population was 50.1±15.5 years, 38.1% were male. According to the statistical analysis of Group 1 (n=165), Group 2 (n=88), Group 3 (n=123) and Group 4 (n=91) NLR was statistically different among groups (p<0.001). Group 1 had significantly higher values compared to Group 2 (p=0.001), Group 3 (p=0.002) and Group 4 (p=0.023). In hypertensive patient group, PLR values of Group 1 was significantly higher than Group 2 (p=0.002). Pearson correlation analysis showed that NLR and PLR were correlated with BP variability (r=-0.188, p<0.001 for NLR and r=-0.182 and p<0.001 for PLR). Regression analysis showed NLR (p=0.040), PLR (p=0.021), age (p=0.006) and hypertension (p<0.001) were independent predictors of BP variability.Conclusion: Our findings suggest that NLR and PLR can be used as inexpensive and easily accessible markers to detect non-dipper status in hypertensive patients.