Key result
Normotensive non-dipper patients exhibited significantly elevated systemic immune inflammation index levels (median 821.2) compared to dipper normotensive patients (median 286.9, p<0.001), showing inflammation comparable to dipper hypertensive patients.
Why the study?
Vascular endothelial inflammation contributes to hypertension and diurnal blood pressure variation is a risk factor for target organ damage, prompting evaluation of these inflammatory processes across normotensive and hypertensive patterns.
Does non-dipper normotensive status associate with increased systemic inflammation compared to dipper normotensive status?
Cross-Sectional (n=151)
Does non-dipper normotensive status associate with increased systemic inflammation compared to dipper normotensive status?
Absolute Event Rate: 821.2% vs 286.9%
p-value: p=<0.001
Normotensive non-dipper patients exhibit a systemic inflammatory profile comparable to dipper hypertensive patients, suggesting increased cardiovascular risk despite normal overall blood pressure.
Non-dipping may flag subclinical inflammation in normotensives; leaves open prospective validation of SII for risk stratification.
Objective: Continuous inflammation at the level of the vascular endothelium plays an important role in the formation of hypertension. Diurnal blood pressure (BP) variation also is a risk factor for hypertensive target organ damage. This study planned to evaluate these inflammation processes in normotensive and hypertensive patients. Methods: This study is observational cross-sectional cohort in-design. 151 patients with a prediagnosis of hypertension included. The patients were divided into three groups (group 1: dipper normotensive, group 2: non-dipper normotensive, group 3: dipper-hypertensive) based on the results of ambulatory blood pressure monitoring. The groups were compared in terms of systemic inflammation index (SII; platelet count×neutrophil count/lymphocyte count), neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and other inflammation processes. Results: There was a significant difference between the three groups in terms of mean platelet volume (MPV) and red blood cell distribution width (RDW) levels (p=0.001 and p<0.001, respectively). A statistically significant difference was found between the groups in terms of NLR, PLR, systemic inflammation index, lymphocyte-monocyte ratio (LMR). In subgroup analysis, NLR and systemic inflammation index were similar in group 2 and group 3, but higher than in group 1 in both groups. LMR was similar in group 2 and group 3 but lower than in group 1. In subgroup analysis PLR levels were similar in group 2 and group 3 but higher than group 1 in both groups. Conclusion: This study showed that normotensive non-dipper patients had inflammation as much as dipper hypertensive patients according to measurement of MPV, RDW systemic inflammation index, PLR, NLR levels.
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Emlek et al. (2021) conducted a cross-sectional in Hypertension (n=151). Non-dipper normotensive blood pressure pattern vs. Dipper normotensive pattern was evaluated on Systemic immune inflammation index (SII) (p=<0.001). Normotensive non-dipper patients exhibited significantly elevated systemic immune inflammation index levels (median 821.2) compared to dipper normotensive patients (median 286.9, p<0.001), showing inflammation comparable to dipper hypertensive patients.
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