Linking Inflammation to Non-Dipper Hypertension: Diagnostic Utility of Neutrophil Percentage-to-Albumin Ratio

Background Hypertension (HT) constitutes a pervasive global health challenge, standing as a principal contributor to cardiovascular morbidity and mortality. Limited data are available regarding the relationship between NPAR and non-dipper hypertension. we aimed to investigate whether NPAR is independently associated with non-dipper status in newly diagnosed hypertensive patients. Methods Prospectively, 160 hypertensive patients were included in the study. After a 24-h ABPM assessment, the patients were divided into two groups, a dipper group and a non-dipper and 80 healthy control subjects were enrolled in the study. Baseline laboratory and echocardiographic parameters were measured and then the NPAR was calculated. Results Levels of WBC, NLR, hs-CRP were significantly higher in patients with non-dipper HT than dipper HT and control subjects. Echocardiographic assessments revealed that the LV wall was thicker and LV mass index were higher in the hypertensive group than the control group. NPAR levels were significantly different among the three groups (p < 0.001) and also the multivariate analysis revealed that higher NPAR and hs-CRP levels were independently associated with a non-dipping pattern. ROC analysis showed that NPAR levels higher than 22.2 can predict non-dipping status (p < 0.001). Conclusions Our study shows that higher NPAR levels are independently associated with non-dipper hypertension in newly diagnosed hypertensive patients. These findings emphasize the role of inflammation in the pathophysiology of circadian BP variation and suggest that NPAR may serve as a useful tool in identifying hypertensive patients at higher risk for cardiovascular complications.