Yeni Tanı Almış Esansiyel Hipertansiyon Hastalarında Sistemik İmmün İnflamatuar İndeksi ve Sabah Kan Basıncı Dalgalanması Arasındaki İlişkinin Değerlendirilmesi
Abstract
Amaç: Bu çalışma, yeni tanı konmuş esansiyel hipertansiyon hastalarında Sistemik İmmün-İnflamatuar İndeks (Sİİ) ile Sabah Kan Basıncı Yükselmesi (SKBY) arasındaki ilişkiyi araştırmayı amaçlamaktadır.
Araçlar ve Yöntem: Nisan ve Haziran 2024 tarihleri arasında, kardiyoloji polikliniğinden 217 kontrol ve 188 hipertansif hastadan oluşan 405 katılımcıyı içeren kesitsel bir çalışma yapılmıştır. Katılımcıların kan basıncı, Ayaktan Kan Basıncı İzleme (AKBİ) kullanılarak izlenmiş ve Sİİ dahil inflamatuar belirteçler değerlendirilmiştir. Sİİ, platelet sayısının nötrofil sayısıyla çarpılması ve lenfosit sayısına bölünmesiyle hesaplanmıştır. İstatistiksel analizler, SKBY'yi öngörmede Sİİ'nin değerini değerlendirmek için ROC eğrisi analizini içermektedir.
Bulgular: Hipertansif hastalar, kontrol grubuna kıyasla 24 saatlik, gündüz ve gece sistolik ve diyastolik kan basıncı değerlerinin anlamlı derecede yüksek olduğunu göstermiştir (hepsi p<0.001). SKBY ve Sİİ de hipertansif grupta anlamlı derecede yükselmiştir (her ikisi de p=0.003). ROC analizi, Sİİ'nin 27.3 mmHg'nin üzerinde SKBY 'yi öngörmede 577.38 kesim değeri ile %56.4 duyarlılık ve %67 özgüllükle 0.645 (p=0.001) AUC'ye sahip olduğunu göstermiştir. Yüksek nötrofil ve platelet sayıları, daha yüksek kan basıncı seviyeleri ve kardiyovasküler risk ile ilişkilendirilmiştir.
Sonuç: Çalışma, hipertansif hastalarda Sİİ ve SKBY arasında anlamlı bir ilişki olduğunu belirlemiş, bu da sistemik inflamasyonun kan basıncının düzenlenmesinde ve hipertansiyonun patogenezinde rol oynayabileceğini önermektedir. Sİİ, SKBY ve ilgili kardiyovasküler riskleri öngörmede değerli bir biyomarker olarak kullanılabilir ve daha erken ve daha hedeflenmiş müdahaleleri kolaylaştırabilir.
Keywords
enflamatuar belirteçler kan basıncı değişkenliği kardiyovasküler hastalık kardiyovasküler risk
References
- 1. Kumbhani DJ, Steg PG, Cannon CP, et al. Resistant hypertension: a frequent and ominous finding among hypertensive patients with atherothrombosis. Eur Heart J. 2013;34(16):1204-1214.
- 2. Messerli FH, Williams B, Ritz E. Essential hypertension. Lancet. 2007;370(9587):591-603.
- 3. Ferdinand, K. C., & Nasser, S. A.. Management of essential hypertension. Cardiol. Clin. 2017;35(2):231-246.
- 4. Montecucco F, Pende A, Quercioli A, Mach F. Inflammation in the pathophysiology of essential hypertension. J Nephrol. 2011;24(1):23-34.
- 5. Agita A, Alsagaff MT. Inflammation, immunity, and hypertension. Acta Med Indones. 2017;49(2):158.
- 6. Özen Y, Erdöl A, Özbay MB, Erdoğan M. The Prognostic Role of the Systemic Inflammatory Index (SII) in Heart Failure Patients: Systemic Inflammatory Index and Heart Failure. IJCMBS. 2023;3(1):45-50.
- 7. Shang J, Han X, Zha H, et al. Systemic immune-inflammation index and changes of neutrophil-lymphocyte ratio as prognostic biomarkers for patients with pancreatic cancer treated with immune checkpoint blockade. Front Oncol. 2021;11:585271.
- 8. Atkinson G, Jones H, Ainslie PN. Circadian variation in the circulatory responses to exercise: relevance to the morning peaks in strokes and cardiac events. Eur J Appl Physiol. 2010;108:15-29.
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- 12. Erdoğan M, Erdöl MA, Öztürk S, Durmaz T. Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis. Biomark Med. 2020;14(16):1553-1561.
- 13. Saylik F, Sarıkaya R. Can systemic immune-inflammation index detect the presence of exxaggerated morning blood pressure surge in newly diagnosed treatment-naive hypertensive patients? Clin Exp Hypertens. 2021;43(8):772-779.
- 14. Crowley SD. The cooperative roles of inflammation and oxidative stress in the pathogenesis of hypertension. Antioxid Redox Signal. 2014;20(1):102-120.
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- 17. Xu J-P, Zeng R-X, Zhang Y-Z, et al. Systemic inflammation markers and the prevalence of hypertension: A NHANES cross-sectional study. Hypertens Res. 2023;46(4):1009-1019.
Evaluation of the Relationship Between Systemic Immune-Inflammatory Index and Morning Blood Pressure Surge in Newly Diagnosed Essential Hypertension Patients
Abstract
Purpose: This study aims to explore the relationship between the Systemic Immune-Inflammatory Index (SII) and Morning Blood Pressure Surge (MBPS) in patients with newly diagnosed essential hypertension.
Materials and Methods: A cross-sectional study was conducted between April and June 2024, involving 405 participants, 217 controls, and 188 hypertensive patients, recruited from a cardiology outpatient clinic. Participants' blood pressure was monitored using Ambulatory Blood Pressure Monitoring (ABPM), and inflammatory markers, including SII, were assessed. SII was calculated by multiplying platelet count by neutrophil count and dividing by lymphocyte count. Statistical analysis included ROC curve analysis to evaluate SII's predictive value for MBPS.
Results: Hypertensive patients exhibited significantly higher 24-hour, daytime, and nighttime systolic and diastolic blood pressure values compared to controls (all p<0.001). MBPS and SII were also significantly elevated in the hypertensive group (both p=0.003). ROC analysis demonstrated that SII had an AUC of 0.645 (p=0.001) with a sensitivity of 56.4% and specificity of 67% at a cut-off value of 577.38 for predicting MBPS greater than 27.3 mmHg. Elevated neutrophil and platelet counts were associated with higher blood pressure levels and cardiovascular risk.
Conclusion: The study identified a significant association between SII and MBPS in hypertensive patients, suggesting that systemic inflammation may play a role in the regulation of blood pressure and the pathogenesis of hypertension. SII could serve as a valuable biomarker for predicting MBPS and associated cardiovascular risks, facilitating earlier and more targeted interventions.
Ethical Statement
Sağlık Bilimleri Bilimsel Araştırmalar Etik Kurulu Ahi Evran Üniversitesi (Approval No: 2024-12/98, Date: 01.06.2024).
References
- 1. Kumbhani DJ, Steg PG, Cannon CP, et al. Resistant hypertension: a frequent and ominous finding among hypertensive patients with atherothrombosis. Eur Heart J. 2013;34(16):1204-1214.
- 2. Messerli FH, Williams B, Ritz E. Essential hypertension. Lancet. 2007;370(9587):591-603.
- 3. Ferdinand, K. C., & Nasser, S. A.. Management of essential hypertension. Cardiol. Clin. 2017;35(2):231-246.
- 4. Montecucco F, Pende A, Quercioli A, Mach F. Inflammation in the pathophysiology of essential hypertension. J Nephrol. 2011;24(1):23-34.
- 5. Agita A, Alsagaff MT. Inflammation, immunity, and hypertension. Acta Med Indones. 2017;49(2):158.
- 6. Özen Y, Erdöl A, Özbay MB, Erdoğan M. The Prognostic Role of the Systemic Inflammatory Index (SII) in Heart Failure Patients: Systemic Inflammatory Index and Heart Failure. IJCMBS. 2023;3(1):45-50.
- 7. Shang J, Han X, Zha H, et al. Systemic immune-inflammation index and changes of neutrophil-lymphocyte ratio as prognostic biomarkers for patients with pancreatic cancer treated with immune checkpoint blockade. Front Oncol. 2021;11:585271.
- 8. Atkinson G, Jones H, Ainslie PN. Circadian variation in the circulatory responses to exercise: relevance to the morning peaks in strokes and cardiac events. Eur J Appl Physiol. 2010;108:15-29.
- 9. Mokwatsi GG. Morning blood pressure surge and its association with arterial function and subclinical target organ damage in young South Africans: the African-PREDICT study. Eur J Prev Cardiol. 2019;26(5): 458-470.
- 10. Cuspidi C, Tadic M, Grassi G, Mancia G. Treatment of hypertension: The ESH/ESC guidelines recommendations. Pharmacol Res. 2018;128:315-321.
- 11. Kario K, Shimada K, Pickering TG. Clinical implication of morning blood pressure surge in hypertension. J Cardiovasc Pharmacol. 2003;42:87-91.
- 12. Erdoğan M, Erdöl MA, Öztürk S, Durmaz T. Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis. Biomark Med. 2020;14(16):1553-1561.
- 13. Saylik F, Sarıkaya R. Can systemic immune-inflammation index detect the presence of exxaggerated morning blood pressure surge in newly diagnosed treatment-naive hypertensive patients? Clin Exp Hypertens. 2021;43(8):772-779.
- 14. Crowley SD. The cooperative roles of inflammation and oxidative stress in the pathogenesis of hypertension. Antioxid Redox Signal. 2014;20(1):102-120.
- 15. Patti G, Di Martino G, Ricci F. et al. Platelet indices and risk of death and cardiovascular events: results from a large population-based cohort study. Thromb. Haemost. 2019;119(11):1773-1784.
- 16. Sun X, Luo L, Zhao X, Ye P, Du R. The neutrophil-to-lymphocyte ratio on admission is a good predictor for all-cause mortality in hypertensive patients over 80 years of age. Bmc Cardiovasc Disord. 2017;17:1-9.
- 17. Xu J-P, Zeng R-X, Zhang Y-Z, et al. Systemic inflammation markers and the prevalence of hypertension: A NHANES cross-sectional study. Hypertens Res. 2023;46(4):1009-1019.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Original Articles |
| Authors | |
| Early Pub Date | April 16, 2025 |
| Publication Date | April 21, 2025 |
| Submission Date | July 30, 2024 |
| Acceptance Date | November 4, 2024 |
| Published in Issue | Year 2025 Volume: 9 Issue: 1 |
Cite
Ahi Evran Medical Journal is indexed in ULAKBIM TR Index, Turkish Medline, DOAJ, Index Copernicus, EBSCO and Turkey Citation Index. Ahi Evran Medical Journal is periodical scientific publication. Can not be cited without reference. Responsibility of the articles belong to the authors.
