Systemic Immune-inflammation Index as a Marker for Asymptomatic Organ Damage in Newly Diagnosed Hypertension – A Cross-sectional Study

BACKGROUND: Systemic inflammation contributes to hypertension-mediated organ damage. The Systemic Immune-Inflammation Index (SII), derived from peripheral blood counts, has emerged as a potential marker, but data in newly diagnosed, treatment-naïve hypertensive patients in India are limited. OBJECTIVE: To evaluate the association between SII and the presence and severity of asymptomatic organ damage (AOD) in newly diagnosed hypertension. MATERIALS AND METHODS: This hospital-based, cross-sectional study was conducted at a tertiary care center over 2 years. Sixty-six adults with newly diagnosed, treatment-naïve hypertension were included. SII was calculated as platelet count × neutrophil count/lymphocyte count. AOD was assessed using urine albumin-to-creatinine ratio, left ventricular mass index, carotid intima-media thickness, and fundus examination. Organ damage severity was graded by the number of organs involved. Correlation and receiver operating characteristic analyses were performed. RESULTS: The mean age was 51.88 ± 12.1 years and 54.5% were male. AOD was present in 90.9% of patients. Median SII values were significantly higher in patients with renal involvement, left ventricular hypertrophy, increased carotid intima-media thickness, and hypertensive retinopathy (all P < 0.0001). SII increased progressively with higher AOD grades (P < 0.0001) and showed significant positive correlations with urine albumin-to-creatinine ratio, left ventricular mass index, and carotid intima-media thickness. The area under the curve for SII in detecting AOD was 0.812. CONCLUSION: Higher SII was significantly associated with the presence and severity of AOD in newly diagnosed hypertension and may aid early risk stratification.