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OS 14-09 EPICARDIAL FAT THICKNESS AND NEUTROPHIL TO LYMPHOCYTE RATIO ARE INCREASED IN THE NON-DIPPER PATTERN.
Journal of Hypertension 2016 September
OBJECTIVE: Epicardial fat tissue reflects visceral adiposity and inflammation, and neutrophil to lymphocyte ratio (NLR) has been investigated as important inflammatory marker in cardiovascular disease. We aimed to investigate the relationship of echocardiographic epicardial fat thickness (EFT) and NLR with diurnal blood pressure (BP) changes in patients with recently diagnosed essential hypertension.
DESIGN AND METHOD: A total of 647 hypertensive patients underwent echocardiography and 24-hours ambulatory BP monitoring. EFT was measured with echocardiography, while NLR was measured by dividing neutrophil count by lymphocyte count. The patients were categorized into three groups according to their BP pattern: 112 patients (17.3%) were in the normotensive group, 269 patients (41.6%) were in the dipper hypertensive group and 266 patients (41.1%) were in the non-dipper hypertensive group.
RESULTS: The mean EFT of the non-dipper group was significantly higher in both hypertensive groups as compared to the control group and was the highest in the non-dipper group (non-dipper; 7.3 ± 3.0 vs. dipper; 6.1 ± 2.0 vs. normotensive; 5.5 ± 1.9 mm, p < 0.001). NLR was the highest in the non-dipper group than those of dipper group and normotensive group (non-dipper, 2.75 ± 2.81; dipper, 2.01 ± 1.32; control, 1.92 ± 1.11; p < 0.001). EFT was significantly correlated with age (r = 0.160, p < 0.001), body mass index (r = 0.091, p = 0.042), 24 hours mean BP variability (r = 0.152, p = 0.001), and NLR (r = 0.353, p < 0.001). Furthermore, An EFT > 6.9 mm was associated with the non-dipper BP pattern with 49.8% sensitivity and 71.5% specificity (p = 0.005). In a multivariate analysis, EFT (adjusted odds ratio, OR = 2.97, 95% CI = 1.17-7.50, p = 0.022) and NLR (OR = 1.20, 95% CI = 1.04-1.37, p = 0.012) were independent predictors of a non-dipper pattern after adjustment of cardiovascular risk factors.
CONCLUSIONS: EFT and NLR are independently associated with impaired diurnal blood pressure profiles in the hypertensive individuals. EFT measured by echocardiography and NLR appears to be helpful in cardiometabolic risk stratification.
DESIGN AND METHOD: A total of 647 hypertensive patients underwent echocardiography and 24-hours ambulatory BP monitoring. EFT was measured with echocardiography, while NLR was measured by dividing neutrophil count by lymphocyte count. The patients were categorized into three groups according to their BP pattern: 112 patients (17.3%) were in the normotensive group, 269 patients (41.6%) were in the dipper hypertensive group and 266 patients (41.1%) were in the non-dipper hypertensive group.
RESULTS: The mean EFT of the non-dipper group was significantly higher in both hypertensive groups as compared to the control group and was the highest in the non-dipper group (non-dipper; 7.3 ± 3.0 vs. dipper; 6.1 ± 2.0 vs. normotensive; 5.5 ± 1.9 mm, p < 0.001). NLR was the highest in the non-dipper group than those of dipper group and normotensive group (non-dipper, 2.75 ± 2.81; dipper, 2.01 ± 1.32; control, 1.92 ± 1.11; p < 0.001). EFT was significantly correlated with age (r = 0.160, p < 0.001), body mass index (r = 0.091, p = 0.042), 24 hours mean BP variability (r = 0.152, p = 0.001), and NLR (r = 0.353, p < 0.001). Furthermore, An EFT > 6.9 mm was associated with the non-dipper BP pattern with 49.8% sensitivity and 71.5% specificity (p = 0.005). In a multivariate analysis, EFT (adjusted odds ratio, OR = 2.97, 95% CI = 1.17-7.50, p = 0.022) and NLR (OR = 1.20, 95% CI = 1.04-1.37, p = 0.012) were independent predictors of a non-dipper pattern after adjustment of cardiovascular risk factors.
CONCLUSIONS: EFT and NLR are independently associated with impaired diurnal blood pressure profiles in the hypertensive individuals. EFT measured by echocardiography and NLR appears to be helpful in cardiometabolic risk stratification.
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