title: Blood Neutrophil to Lymphocyte Ratio as a Predictor of Hypertension.
abstract: BACKGROUND
  Hypertension is a significant global public health challenge. Low-grade inflammation is known to facilitate the development of essential hypertension and target-organ hypertensive damage. Neutrophil to lymphocyte ratio (NLR) is a simple and reliable indicator of inflammation that may also be useful in the prediction of hypertension.
  
  
  METHODS
  Participants were recruited from Tianjin Medical University's General Hospital-Health Management Centre. A total of 28,850 initially hypertension-free subjects were followed from 2007 to 2013. Adjusted Cox proportional hazards regression models were used to assess relationships between NLR categories and incidence of hypertension.
  
  
  RESULTS
  During the ~6-year follow-up period (median duration of follow-up (interquartile range): 2.63 (2.58-2.68)), 1,824 subjects developed hypertension. The hazard ratios of hypertension incidence were evaluated in increasing NLR quintiles. Compared with participants with the lowest NLR levels, the multivariable-adjusted hazard ratios (95% confidence interval) of hypertension were related to increasing NLR quintiles and were as follows: 1.08 (0.92, 1.26), 0.97 (0.83, 1.14), 1.10 (0.94, 1.28), and 1.23 (1.06, 1.43), respectively (P for trend < 0.01). Similar results also were observed in the white blood cell and neutrophil counts, but not lymphocyte counts.
  
  
  CONCLUSIONS
  The study is the first to show the elevated NLR levels significantly correlate with an increased risk of developing hypertension. This result may be useful in elucidating the mechanism underlying the development of hypertension. New therapeutic approaches aimed at inflammation might be proposed to control hypertension and hypertensive damage.
authors.affiliation: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China;
authors.forename: Xing
authors.initials: X
authors.lastname: Liu
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China;
authors.forename: Hongmei
authors.initials: H
authors.lastname: Wu
authors.affiliation: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China;
authors.forename: Huanmin
authors.initials: H
authors.lastname: Du
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Hongbin
authors.initials: H
authors.lastname: Shi
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Chongjin
authors.initials: C
authors.lastname: Wang
authors.affiliation: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China;
authors.forename: Yang
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China;
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Guo
authors.affiliation: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China;
authors.forename: Chunlei
authors.initials: C
authors.lastname: Li
authors.affiliation: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China;
authors.forename: Xue
authors.initials: X
authors.lastname: Bao
authors.affiliation: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China;
authors.forename: Qian
authors.initials: Q
authors.lastname: Su
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Shaomei
authors.initials: S
authors.lastname: Sun
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Wang
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhou
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Qiyu
authors.initials: Q
authors.lastname: Jia
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Honglin
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Song
authors.affiliation: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China. nkj0809@gmail.com nkj0809@163.com.
authors.forename: Kaijun
authors.initials: K
authors.lastname: Niu
mesh_terms: D000328:Adult; D002681:China; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis; D007958:Leukocyte Count / Q000379:methods; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000379:methods
keywords: blood pressure; hypertension; inflammatory markers; neutrophil to lymphocyte ratio.