What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=143). Intervention: Non-dipper hypertension vs. Dipper hypertension. Primary outcome: Monocyte/HDL ratio (p=<0.001).

March 2, 2020Open Access

Monocyte/HDL ratio predicts hypertensive complications

Q: What are the key findings of this study?

Monocyte/HDL ratio was significantly higher in patients with non-dipper hypertension compared to dipper hypertension (0.029 vs 0.013, p<0.001) and was associated with end-organ damage.

IKIan KaplanState University of New York MKMark KaplanIndiana University School of Medicine ÖAÖzge Özcan AbacıoğluSağlık Bilimleri Üniversitesi

Key Result

Monocyte/HDL ratio was significantly higher in patients with non-dipper hypertension compared to dipper hypertension (0.029 vs 0.013, p<0.001) and was associated with end-organ damage.

Study Design

Type

Cross-Sectional (n=143)

Multicenter

Structured PICO

Does the monocyte/HDL ratio predict end-organ damage in patients with dipper and non-dipper hypertension?

Population

143 patients with hypertension (73 dipper, 70 non-dipper) were evaluated to determine the association between monocyte/HDL ratio and hypertensive end-organ damage.

Exposure

Monocyte/HDL ratio (MHR) assessment

Comparator

Dipper hypertension (≥ 10% drop in blood pressure at night) vs Non-dipper hypertension (< 10% drop in blood pressure at night)

Outcome

Presence of hypertensive end-organ damage (left ventricular hypertrophy, hypertensive retinopathy, and hypertensive nephropathy measured by spot urine protein/creatinine)surrogate

The monocyte/HDL ratio is a simple, non-invasive marker that correlates with non-dipper hypertension status and the presence of hypertensive end-organ damage such as left ventricular hypertrophy and retinopathy.

Main Result

Absolute Event Rate: 0.029% vs 0.013%

p-value: p=<0.001

Limitations

Small sample size
Single-center study
Cross-sectional design limits causal inference

Abstract

OBJECTIVE: We aimed to investigate whether a simple and easily calculated parameter such as monocyte/ HDL ratio (MHR) may be used in predicting non-dipper (NDHT)-dipper HT (DHT) end organ damage. METHODS: 70 NDHT and 73 DHT patient groups were included in the study according to ambulatory blood pressure screening results. Basic laboratory parameters and spot urine samples were evaluated. Transthoracic echocardiography and ophthalmological examination were performed for end-organ damages. RESULTS: The MHR among the groups was higher in the NDHT group; which was statistically significant (p≤0.001). In the NDHT group, albumin, creatinine, protein values, protein/creatinine ratio in the spot urine were significantly higher than in the DHT group (p≤0.05). Left ventricular hypertrophy (LVH) and retinopathy were also more frequently observed in the NDHT group (p≤0.001 and p=0.001, respectively). MHR in patients with LVH and retinopathy was significantly higher than in those without these complications (p=0.001). CONCLUSION: Easy to use, non-invasive and simple calculation, MHR can be used to predict end organ damage in hypertensive cases, and can be also used to distinguish between DHT/NDHT groups. This data supports the role of inflammation (Tab. 7, Ref. 14).

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