title: The relationship between neutrophil to lymphocyte ratio and blood pressure variability in hypertensive and normotensive subjecs.
abstract: OBJECTIVE
  Blood pressure (BP) variability is associated with hypertensive (HT) target organ damage and cardiovascular events. The aim of this study was to investigate the relation between neutrophil to lymphocyte ratio (NLR) and BP variability in hypertensive and normotensive subjects.
  
  
  METHODS
  In this cross-sectional study, 150 subjects (63 male, mean age 52.1±5.2 years) were enrolled. In all patients, blood samples and 24-hour ambulatory blood pressure (BP) monitoring were obtained. According to 24-hour ambulatory BP results, participants were divided into four investigation categories. Group 1= Normotensive dipper (ND), Group 2= Normotensive non-dipper (NN), Group 3= HT dipper (HD), Group 4= HT non-dipper (HN).
  
  
  RESULTS
  Highest NLR values were determined in the HN group (p=0.005 vs. ND, p=0.046 vs. NN and p<0.01 vs. HD). NLR values were similar among the ND, NN and HD groups (p>0.05, for all). NLR was correlated with night systolic blood pressure (SBP) (r=0.178, p=0.031), night diastolic blood pressure (DBP) (r=0.176, p=0.032) and BP variation rate (r=-0.246, p=0.003). Multiple linear regression analysis showed BP variation rate to be an independent predictor of high NLR value (ß=0.186, 95% CI=0.918-0.982, p=0.044). In ROC analysis, a level of NLR>2.7 predicted non-dipper HT with 83% sensitivity and 65% specificity (ROC area under curve: 0.653, 95% CI=0.565-0.741, p=0.001).
  
  
  CONCLUSIONS
  In the present study, we found that NLR levels were significantly correlated with BP variability. The measurement of NLR may be used to indicate increased risk of HT-related adverse cardiovascular events.
authors: Department of Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey. kilicaslanbaris@yahoo.com.
authors: Barış
authors: B
authors: Kılıçaslan
authors: Department of Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
authors: Hüseyin
authors: H
authors: Dursun
authors: Department of Internal Medicine, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
authors: Sermin
authors: S
authors: Kaymak
authors: Department of Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
authors: Mehmet
authors: M
authors: Aydın
authors: Department of Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
authors: Cenk
authors: C
authors: Ekmekçi
authors: Department of Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
authors: İbrahim
authors: İ
authors: Susam
authors: Department of Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
authors: Öner
authors: Ö
authors: Özdoğan
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D007958:Leukocyte Count; D016014:Linear Models; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology*; D012372:ROC Curve