A New Score for the Identification of Circadian Blood Pressure Pattern in Hypertensive Patients

Year 2025, Volume: 22 Issue: 2, 301 - 306, 27.06.2025

Halil Fedai , Ali Nizami Elmas , İsmail Demir

Abstract

Background: Non-dipper hypertension is characterised by a decrease of less than 10% in nocturnal blood pressure compared to daytime levels. It is known that non-dipper hypertension is associated with higher mortality than dipper hypertension. Therefore, in this study, we aimed to investigate the correlation between the easily calculable LANR score in the diagnosis of non-dipper HT.
Materials and Methods: A total of 524 patients diagnosed with HT who were admitted to the a cardi-ology clinic were included in this study. Demographic data, 24-hour ambulatory blood pressure moni-toring, echocardiographic, and laboratory data were obtained from hospital archives. The formula LANR = lymphocytes × albumin / neutrophils was used to calculate the LANR index. Patients were catego-rized into two groups, namely LANR<23 and LANR>23.
Results: When baseline demographic characteristics and laboratory parameters were compared, no significant difference was found between the two groups except neutrophils, lymphocytes and C reac-tive protein. CAR and NLR were found to be high in the non-dipper HT group, while HALP and LANR were found to be low. In addition, in stepwise multivariate analyses performed to determine the predictors of the prognostic process in non-dipper HT patients, CAR (odds ratio: 1.420, 95% confidence interval: 1.106-1.823, P<0.001) and LANR (odds ratio: 0.583, 95% confidence interval: 0.493-0.690, P<0.001) were identified as independent predictors of HT in non-dipper HT.
Conclusions: This study showed lower LANR, HALP scores and higher CAR, NLR scores in non-dipper HT patients compared with dipper HT patients. Furthermore, LANR and CAR were identified as indepen-dent predictors of non-dipper HT In addition, the rate of non-dipper hypertension was reported to be significantly higher in patients with LANR<23 than in individuals with LANR>23. In conclusion, a low LANR index can be used as an early warning model to identify patients with non-dipper HT.

Keywords

lymphocyt , albumin , neutrophil , dipper , non-dipper , hypertension

Ethical Statement

İzmir Bozkaya Eğitim ve Araştırma Hastanesi Sağlık Araştırmaları Etik Kurulu KARAR NO: 2024/14

Hipertansif Hastalarda Sirkadiyen Kan Basıncı Paterninin Belirlenmesi için Yeni Bir Skor

Abstract

Amaç: Non-dipper hypertension is characterised by a decrease of less than 10% in nocturnal blood pressure compared to daytime levels. It is known that non-dipper hypertension is associated with higher mortality than dipper hypertension. Therefore, in this study, we aimed to investigate the correlation between the easily calculable LANR score in the diagnosis of non-dipper HT.
Material ve Metod: Bir kardiyoloji kliniğine başvuran ve HT tanısı alan toplam 524 hasta bu çalışmaya dahil edilmiştir. Demografik veriler, 24 saatlik ambulatuvar kan basıncı monitörizasyonu, ekokardiyografik ve laboratuvar verileri hastane arşivlerinden elde edilmiştir. LANR indeksini hesaplamak için LANR = lenfosit × albümin / nötrofil formülü kullanılmıştır. Hastalar LANR<23 ve LANR>23 olmak üzere iki gruba ayrılmıştır.
Bulgular: Başlangıçtaki demografik özellikler ve laboratuar parametreleri karşılaştırıldığında iki grup arasında nötrofil, lenfosit, C reaktif protein dışında anlamlı bir farklılık bulunmamıştır. Non-dipper HT grubunda CAR ve NLR yüksek saptanırken, HALP ve LANR düşük olarak saptanmıştır. Ayrıca dipper olmayan HT hastalarında prognostik sürecin öngörücülerini belirlemek için yapılan aşamalı çok değişkenli analizlerde, CAR (odds oranı:1.420, %95 güven aralığı:1.106-1.823, P<0.001) ve LANR (odds oranı:0.583, %95 güven aralığı:0.493-0.690, P<0.001) dipper olmayan HT'de HT'nin bağımsız öngörücüleri olarak tanımlanmıştır.
Sonuç: Bu çalışmada, non-dipper HT hastalarında dipper HT hastalarına kıyasla daha düşük LANR, HALP skorları ve daha yüksek CAR, NLR skorları gösterilmiştir. Ayrıca, LANR ve CAR, damlayıcı olmayan HT'nin bağımsız belirleyicileri olarak tanımlanmıştır. Buna ek olarak, damlayıcı olmayan hipertansiyon oranının LANR<23 olan hastalarda LANR>23 olan bireylere göre anlamlı derecede daha yüksek olduğu bildirilmiştir. Sonuç olarak, düşük LANR indeksi, damlamayan HT hastalarını belirlemek için bir erken uyarı modeli olarak kullanılabilir.

Keywords

lenfosit , albümin , nötrofil , dipper , non-dipper , hipertansiyon

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