The relationship between the prognostic nutritional index and non-dipping blood pressure pattern in patients with newly diagnosed hypertension

Abstract

Aims: It has been suggested that immuno-nutritional status may play a role in blood pressure (BP) variations. This study aimed to investigate whether prognostic nutritional index (PNI) values differ between normotensive individuals and patients with newly diagnosed untreated hypertension (NDHT) and to clarify the relationship between the PNI and circadian BP patterns in NDHT patients. Methods: This retrospective study included 328 adult participants, comprising 164 NDHT patients and 164 normotensive individuals. The non-dipper BP pattern (NDP) was defined as a nighttime decline in BP of less than 10%. The PNI was calculated using the following formula: PNI=([10 × serum albumin (g/dL)] + [0.005 × total lymphocyte count]). Results: The mean PNI value was lower in the NDHT group than the normotensive group (53.6±6.1 vs. 58.2±5.3, p<0.001). There was a positive correlation between the PNI and the decline in nighttime BP levels (r=0.517; p<0.001). NDP was identified in 45.1% (n=74) of the NDHT patients. The mean PNI value was lower in the NDP group compared to the dipper BP group (49.9±5.6 vs. 56.6±4.8, p<0.001). Decreased PNI was an independent predictor of NDP (OR=0.70, 95% CI=0.61-0.81, p<0.001). The cut-off value of the PNI in predicting NDP was established as ≤51.3 with 72.4% sensitivity and 69.8% specificity. Conclusion: Patients with hypertension had poorer immuno-nutritional statuses and a low PNI value was an important predictor of NDP. The PNI may be a useful screening tool for circadian BP patterns in patients with NDP.

Keywords

• Circadian rhythm
• hypertension
• nutritional status
• prognostic nutritional index

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