Journal of Inflammation Research (Nov 2022)

Associations of Inflammation with Risk of Cardiovascular and All-Cause Mortality in Adults with Hypertension: An Inflammatory Prognostic Scoring System

  • Cheang I,
  • Zhu X,
  • Lu X,
  • Yue X,
  • Tang Y,
  • Gao R,
  • Liao S,
  • Yao W,
  • Zhou Y,
  • Zhang H,
  • Yiu KH,
  • Li X

Journal volume & issue
Vol. Volume 15
pp. 6125 – 6136

Abstract

Read online

Iokfai Cheang,1,2,* Xu Zhu,1,* Xinyi Lu,1 Xin Yue,1 Yuan Tang,1 Rongrong Gao,1 Shengen Liao,1 Wenming Yao,1 Yanli Zhou,1 Haifeng Zhang,1,3 Kai-Hang Yiu,2,4 Xinli Li1 1Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, People’s Republic of China; 2Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, 999077, People’s Republic of China; 3Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, People’s Republic of China; 4Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, 518000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xinli Li, Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, People’s Republic of China, Tel +86 13611573111, Email [email protected] Kai-Hang Yiu, Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, 999077, People’s Republic of China, Tel +852 22553633, Fax +852 28186304, Email [email protected]: Inflammation is one of the major pathways in the progression of hypertension (HTN), and the related inflammatory markers have demonstrated certain predictive values. The current study aimed to integrate these markers to construct an inflammatory prognostic scoring (IPS) system and to assess the prognostic values of IPS in patients with HTN.Methods: A total of 9846 adult participants with HTN from NHANES 1999– 2010 were enrolled and followed up. Demographic characteristics and the related laboratory results for the 12 inflammatory markers were collected. LASSO-COX regression, Kaplan–Meier, restricted cubic spline COX regression (RCS), receiver operator characteristic curve (ROC), and random survival forests (RSF) analysis were applied to explore the values of individual and IPS parameters.Results: At the census date of follow-up, 2387 (24.2%) were identified as all-cause deaths and 484 (4.9%) as cardiovascular deaths. All inflammatory markers showed certain prognostic values. Then, based on the LAASO analysis, LDH, ALP, LYM, NLR, MLR, SIRI, and RDW were included in the construction of the IPS system. The higher IPS had significantly worse long-term prognosis in Kaplan–Meier analysis (p log-rank 0.05). Two different algorithms of RSF, variable importance and minimal depth, to evaluate the prognostic importance showed that IPS was the best in survival prediction.Conclusion: Our results highlight that a higher IPS (system integrating the inflammatory markers) was associated with the increased risk of cardiovascular and all-cause mortality in patients with HTN, suggesting that IPS is a useful method for risk stratification in HTN.Keywords: hypertension, HTN, inflammation, inflammatory prognostic scoring system, prognosis, random survival forest

Keywords