Correlation Studies Of Neutrophil/High-density Lipoprotein Cholesterol Ratio And Platelet/Lymphocyte Ratio With Risk Stratification Of Essential Hypertension

Background:Essential hypertension is one of the common cardiovascular diseases worldwide and a chronic noncommunicable disease that seriously threatens human health.The severity of hypertension not only depends on blood pressure level,but also needs to be considered in combination with many factors,so risk stratification of hypertensive patients is of great clinical significance,especially in primary clinical practice.In recent years,it has been suggested that the level of inflammatory markers in the blood is related to the occurrence of essential hypertension,but the relationship between the novel inflammatory markers neutrophil/high-density lipoprotein cholesterol ratio(NHR)and platelet/lymphocyte ratio(PLR)and risk stratification of essential hypertension has not been studied.Objective:The aim of this study is to investigate the correlation between NHR and PLR and risk stratification of essential hypertension.Method:A total of 605 patients who were treated and hospitalized in the First Affiliated Hospital of Nanchang University from January 2020 to September 2021 were selected and divided into hypertension group(n=329)and non-hypertensive group(n=276)according to the 2020 International Practice Guidelines for Hypertension of the International Society of Hypertension(referred to as the"ISH 2020 Guidelines"),and then 109 patients with hypertension were divided into low-risk group,108 cases in intermediate-risk group and 112 cases in high-risk group according to the guidelines cardiovascular risk stratification.The general data and clinical data of different groups were compared,and logistic regression was used to analyze the influencing factors of hypertension and its risk stratification.Spearman rank correlation was used to analyze the association between inflammatory markers and hypertension.The receiver operating characteristics(ROC)curve was used to evaluate the predictive value of different indicators on hypertension.Results:1.Hypertension group and non-hypertensive group white blood cells(WBC),neutrophils(NEUT),platelets(PLT),platelet distribution width(PDW),eosinophils(EOS),large platelet ratio(P-LCR),albumin(ALB),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA),fasting blood glucose(FBG),lactate dehydrogenase(LDH),fibrinogen(Fg),NHR,PLR were compared with statistically significant differences(p<0.05);and there were no significant differences in sex,age,red blood cells(RBC),hemoglobin(HB),mean platelet volume(MPV),lymphocytes(LYM),basophils(BAS),red blood cell volume distribution CV(RDW-CV),total cholesterol(TC),and total bilirubin(TB)(p>0.05).2.Compared with BAS and RDW-CV in low-risk group,intermediate-risk group and high-risk group,there was no significant difference(p>0.05);The three groups of gender,age,WBC,RBC,HB,NEUT,LYM,PLT,PDW,MPV,EOS,P-LCR,ALB,TC,TG,HDL-C,LDL-C,TB,ALT,AST,Scr,BUN,UA,FBG,LDH,Hcy,Fg,NHR,PLR,were statistically significant(p<0.05).The NHR of the low-risk group was lower than that of the intermediate-risk group and the high-risk group,and the NHR of the intermediate-risk group was lower than that of the high-risk group,and the difference between the two was statistically significant(p<0.05).3.The results of binary logistic regression analysis showed that NHR(OR=1.958,95%CI:1.679-2.284,p<0.001)and PLR(OR=1.004,95%CI:1.001-1.008,p=0.023)were independent risk factors for hypertension.In the results of multivariate logistic regression analysis,NHR(OR=1.675,95%CI:1.460-1.922,p<0.001)and PLR(OR=1.010,95%CI:1.006-1.014,p<0.001)were independent risk factors for risk stratification of essential hypertension.4.Spearman rank correlation analysis showed that NHR(r_s=0.575,p<0.01)and PLR(r_s=0.317,p<0.01)were positively correlated with the risk stratification of essential hypertension.5.The ROC curve analysis results showed that the area under the curve for NHR to diagnose hypertension was 0.782(95%CI:0.746-0.817),and the best cut-off value was 3.314;The area under the curve for the diagnosis of hypertension by PLR was0.578(95%CI:0.533-0.623),and the best cut-off value was 199.174;The area under the curve for the diagnosis of hypertension by NHR plus PLR was 0.784(95%CI:0.748-0.820).The area under the curve of NHR combined with PLR for hypertension diagnosis was greater than NHR(Z=0.535,p=0.593)and PLR(Z=8.112,p<0.001),respectively.Conclusions:NHR and PLR are correlated with the occurrence and development of essential hypertension,and are independent risk factors for hypertension stratification.