Relationship Between Red Blood Cell Distribution Width And The Risk Levels Of Framingham Cardiovascular Score In Patients With Essential Hypertension

ObjectiveHypertension with the clinical characteristics of sustainable arterial blood pressure increasing may cause heart,brain,kidney,eye and other significant target organ damage.Many clinical studies have found that red blood cell distribution width(RDW)is closely related to acute coronary syndrome(ACS),heart failure(HF),atrial fibrillation(AF),glomerular filtration rate(GFR),pulmonary hypertension,etc.in recent years.However,there are few articles concerning the relationship between RDW and the cardiovascular risk in patients with essential hypertension.The aim of this research is to investigate the association between RDW and the risk levels of Framingham cardiovascular score in patients with essential hypertension.MethodsA total of 383 inpatients and outpatients with essential hypertension in the Department of Cardiology of the Second Affiliated Hospital of Zhengzhou University from September 2014 to August 2016 were enrolled in the study.According to the risk levels of Framingham cardiovascular score,all patients were divided into low-risk(n=176),moderate-risk(n=121)and high-risk group(n=86).Eighty normotensives were enrolled as control group.The indicators of blood lipid,hepatic and renal function,fasting blood glucose,RDW,high-sensitivity C-reactive protein(hs-CRP)and left ventricular ejection fraction(LVEF)value were detected.The height,weight and blood pressure were measured and body mass index(BMI)was calculated.The relationship between RDW and the risk levels of Framingham cardiovascular score was analyzed by ordinalploytomous logistic regression analysis,and receiver operating characteristic(ROC)curve was applied to judge the value of cardiovascular high-risk group.ResultsAmong four groups there was no statistical difference(all P> 0.05)in terms of sex constituent ratio,the alanine aminotransferase(ALT),total cholesterol,triacylglycerol,high density lipoprotein cholesterol(HDL-C),serum creatinine,fasting glucose,left ventricular ejection fraction.There were statistical differences(all P< 0.05)in terms of age,BMI,smoking,diabetes,taking statins,systolic pressure,diastolic blood pressure,low density lipoprotein cholesterol(LDL-C),cystatin C(Cys-C),RDW and hs-CRP among four groups.RDW of high-risk group was higher than that in moderate-risk group [(13.42±0.92)% vs(12.96±0.50)%],and which were higher in the high-risk and moderate-risk group than in low-risk group [(12.83±0.51)%] and control group [(12.69±0.66)%](all P< 0.05).Pearson correlation analysis suggested that RDW was negatively correlated with LDL-C and positively correlated with age,Cys-C,hs-CRP,Framingham cardiovascular risk(r=-0.105,0.182,0.151,0.566 and 0.312 respectively,all P< 0.05).Ordinal ploytomous logistic regression analysis demonstrated that RDW was an independent risk factor for the risk levels of Framingham cardiovascular score after adjusted for age,BMI,smoking,diabetes,taking statins,systolic pressure,diastolic blood pressure,LDL-C,Cys-C,hs-CRP(OR=5.601,95%CI: 1.557-20.146,P< 0.05).ROC curve illuminated RDW value of 12.95%,which was identified as an effective cut-point in predicting the presence or absence of cardiovascular high-risk group with a sensitivity of 75.6% and a specificity of 63.9%.The area under the ROC curve was 0.735(95%CI: 0.676-0.793,P< 0.001).Conclusion1.The RDW level in patients with essential hypertension is apparently higher than that in normotensive crowd.2.Elevated levels of RDW(> 12.95%)is an independent predictor of cardiovascular high-risk groups.3.RDW may be associated with cardiovascular risk level in patients with essential hypertension.