Key result
Children with primary hypertension exhibited significantly higher neutrophil-to-lymphocyte ratios (1.9 vs 1.3) and aortic pulse wave velocities (5.36 vs 4.88 m/s) compared to healthy controls.
Why the study?
The immune system can trigger inflammation leading to blood pressure elevation and arterial damage, but the relation between subclinical inflammation and arterial damage in pediatric primary hypertension needed assessment.
Are markers of subclinical inflammation associated with arterial stiffness in children with primary hypertension?
Cross-Sectional (n=164)
No
Are markers of subclinical inflammation associated with arterial stiffness in children with primary hypertension?
Absolute Event Rate: 1.9% vs 1.3%
p-value: p=0.010
Neutrophil-to-lymphocyte ratio is elevated in children with primary hypertension and correlates with arterial stiffness, suggesting a link between subclinical inflammation and vascular damage.
NLR/PLR/MPV may mark arterial damage in pediatric primary hypertension; leaves open clinical utility pending validation.
INTRODUCTION: The immune system can trigger an inflammatory process leading to blood pressure elevation and arterial damage. The aim of the study was to assess the relation between subclinical inflammation and arterial damage in pediatric patients with primary hypertension (PH) and to establish the usefulness of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios, and mean platelet volume (MPV) as markers of arterial damage in these subjects. MATERIAL AND METHODS: In 119 children with PH (14.94 ±2.76 years) and 45 healthy children (14.91 ±2.69 years) we analyzed markers of subclinical inflammation (NLR, PLR, MPV), clinical and biochemical parameters, office blood pressure, ambulatory blood pressure monitoring (ABPM), central blood pressure, aortic pulse wave velocity (aPWV), augmentation index corrected for heart rates 75 (AIx75HR), carotid intima media thickness (cIMT), and common carotid artery stiffness (E-tracking). RESULTS: Children with PH were characterized by significantly higher neutrophil (3.9 ±1.7 vs. 3.0 ±1.0 [1000/µl], p < 0.001) and platelet counts (271.9 ±62.3 vs. 250.3 ±60.3 [1000/µl], p = 0.047), NLR (1.9 ±1.5 vs. 1.3 ±0.4, p = 0.010), PLR (131.4 ±41.9 vs. 114.7 ±37.6, p = 0.020), aPWV (5.36 ±0.88 vs. 4.88 ±0.92 m/s, p = 0.004), and cIMT (0.46 ±0.07 vs. 0.43 ±0.07 mm, p = 0.002) compared to healthy children. In PH children NLR correlated positively (p < 0.05) with: systolic, diastolic and mean blood pressure in ABPM (r = 0.243, r = 0.216, r = 0.251), aPWV [m/s] (r = 0.241), aPWV Z-score (r = 0.204), and common carotid artery PWVbeta [m/s] (r = 0.202). CONCLUSIONS: There is a link between arterial stiffness and subclinical inflammation in pediatric patients with primary hypertension. Neutrophil-to-lymphocyte ratio may serve as a promising marker of arterial stiffness in pediatric patients affected by primary hypertension.
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Skrzypczyk et al. (2021) conducted a cross-sectional in Primary hypertension (n=164). Primary hypertension vs. Healthy children was evaluated on Neutrophil-to-lymphocyte ratio (NLR) (p=0.010). Children with primary hypertension exhibited significantly higher neutrophil-to-lymphocyte ratios (1.9 vs 1.3) and aortic pulse wave velocities (5.36 vs 4.88 m/s) compared to healthy controls.
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