title: Multiplicative interaction between mean corpuscular volume and red cell distribution width with target organ damage in hypertensive patients.
abstract: BACKGROUND
  Accumulating evidence suggests that increased red cell distribution width (RDW) and mean corpuscular volume (MCV) were both poor prognostic factors for patients with cardiovascular diseases. Recently, the multiplicative interaction between RDW and MCV has been observed for predicting mortality in elderly patients without anemia; however, the relationship between the product of RDW-MCV and hypertension-induced target organ damage (TOD) has not been evaluated.
  
  
  METHODS
  We performed a cross-sectional study in 1115 hypertensive patients. RDW and MCV were determined using automated hematology analyzers. Prevalence of TOD was evaluated by estimated glomerular filtration rate, carotid intima-media thickness, and left ventricular mass index.
  
  
  RESULTS
  The prevalence of TOD was observed to be increased with the RDW or product of RDW-MCV quartiles. Moreover, RDW, MCV and product of RDW-MCV were significantly higher in patients with TOD compared to those without TOD. According to two logistic regression models, the associations of RDW and MCV with TOD were lost after adjustment for other factors. However, product of RDW-MCV remains an independent predictor of TOD, with per 0.4 fL increase in the product of RDW-MCV associated with a 16% increased risk of TOD (P=.012).
  
  
  CONCLUSIONS
  The inclusion of MCV by calculating the product of RDW-MCV appears to enhance the association of RDW with TOD.
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Yu-Liang
authors.initials: YL
authors.lastname: Zhan
authors.affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zou
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Kang
authors.affiliation: Department of Cardiology, The Third Hospital of Nanchang, Nanchang, China.
authors.forename: Ling-Bing
authors.initials: LB
authors.lastname: Xiong
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Yun-Feng
authors.initials: YF
authors.lastname: Wei
mesh_terms: D000368:Aged; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D004909:Erythrocyte Indices / Q000502:physiology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis
keywords: hypertension; mean corpuscular volume; red blood cell distribution width; target organ damage