Correlation Analysis Of Monocyte-to-lymphocyte Ratio (MLR) With Non-dipper Hypertension

Objective: To explore the correlation between monocyte-to-lymphocyte ratio(MLR)and non-dipper hypertension and its predictive value for non-dipper hypertension,and to provide a new theoretical basis for clinical screening of non-dipper hypertensionMethods: 286 patients with essential hypertension admitted to the department of cardiology of the first affiliated hospital of nanchang university from June 2018 to June 2019 were collected.75 patients with normal blood pressure of the same age and gender who underwent physical examination in our hospital during the same period were selected as the control group.All patients with essential hypertension received 24 hours ambulatory blood pressure monitoring after admission,of which 10%≤ nocturnal blood pressure drop rate < 20% is the normal circadian rhythm of blood pressure and refers to the dipper hypertension group(n=122),otherwise,it is the abnormal circadian rhythm of blood pressure and refers to the non-dipper hypertension group(n= 164).The age,gender,height,weight,smoking history and other basic data of all subjects were collected,monocyte count,lymphocyte count,HDL,LDL,total cholesterol,triglyceride,blood glucose,uric acid,creatinine and other indicators were recorded,body mass index(BMI)and MLR values were calculated.Patients with hypertension should also record the course of disease,medication history,24-hour ambulate blood pressure,and other indicators.Logistic regression was used to analyze the risk factors of non-dipper hypertension,ROC curve was used to evaluate the predictive value of MLR for non-dipper hypertension.Results: 1.There was no significant difference in age,gender,BMI,smoking history,total cholesterol,triglyceride,LDL,creatinine among the three groups(P > 0.05).In terms of high-density lipoprotein,blood glucose and uric acid,the difference between the normal blood pressure group and the groups with dipper hypertension and non-dipper hypertension was statistically significant(P < 0.05),while the difference between the groups with dipper hypertension and non-dipper hypertension was not statistically significant(P > 0.05).There was no significant difference in disease course and medication history between the dipper hypertension group and the non-dipper hypertension group(P > 0.05).2.Monocytes count of the three groups was compared,and the difference was statistically significant(P < 0.05).In terms of lymphocyte count,the lymphocyte count of the non-dipper hypertension group was lower than that of the dipper hypertension group and the normal blood pressure group,but only the non-dipper hypertension group and the normal blood pressure group had statistically significant differences between the two groups(P < 0.05).3.The MLR of the non-dipper hypertension group was significantly higher than that of the dipper hypertension group and the normal blood pressure group,with statistically significant differences among the three groups(P < 0.001).4.There was no significant difference in 24 hDBP,dSBP and dDBP between the dipper hypertension group and the non-dipper hypertension group(P > 0.05).In terms of 24 hSBP,nSBP and nDBP,the difference was statistically significant(P < 0.001).5.Multivariate Logistic regression analysis showed that only MLR was independently correlated with non-dipper hypertension(OR=1.273,95% CI 1.193-1.359,P < 0.001).6.ROC curve analysis showed that the area under the MLR curve(AUC)was 0.846(95%CI 0.799-0.893,P < 0.001).When the MLR was 21.04%,the sensitivity was 75.6% and the specificity was 84.4%.Conclusion: 1.Compared with the group with normal blood pressure and the group with dipper hypertension,the MLR of the group with non-dipper hypertension was significantly increased(37.59 vs 18.73 vs 15.58;P<0.001).2.MLR is an independent risk factor for non-dipper hypertension(OR=1.273,95% CI 1.193-1.359,P<0.001),which has a certain predictive value for non-dipper hypertension.