The Relationship Between Dipper / Non-Dipper Pattern and Neutrophil-Lymphocyte Ratio in Patients with Resistant Hypertension

Abstract

INTRODUCTION: Non-Dipper hypertension is associated with increased cardiovascular morbidity and mortality. The neutrophil-lymphocyte ratio (NLR) has been associated with poor outcomes in patients with cardiovascular disease. This study aimed to investigate the relationship between dipper and non-dipper patterns and NLR in resistant hypertension (RHT) patients. METHODS: 164 RHT patients were included in this study. RHT patients were divided into two groups as dipper (n: 76) and non-dipper (n: 88) according to ambulatory blood pressure measurement. NLR was calculated by dividing the number of neutrophils by the number of lymphocytes. RESULTS: 76% of the patients included in the study were female and the average age was 57+-7. Statistically, a significant increase in neutrophil count, red blood cell distribution width (RDW), body mass index and triglyceride values were found in the non-dipper resistant hypertension group compared to the dipper RHT group. Also, the neutrophil-lymphocyte ratio was significantly higher in the non-dipper resistant hypertension group compared to the dipper resistant hypertension group (2.2 (1.94/3.1) vs 1.76 (1.3/2.1)); p <0.001). In the multiple logistic regression analysis, neutrophil-lymphocyte ratio (OR: 2.5, 95% CI: 1.29-4.94, p <0.001) and RDW (OR: 7.1, 95% CI: 3.78-13.4, p <0.001), a significant relationship was found between non-dipper resistant hypertension. DISCUSSION AND CONCLUSION: Our study has shown that the presence of a non-dipper pattern in resistant hypertension patients is associated with inflammation caused by hypertension, and inflammatory indicators such as neutrophil-lymphocyte ratio and RDW were higher in this group of patients.

Keywords

• neutrophil-lymphocyte ratio
• dipper
• non-dipper
• resistant hypertension