Yeni Tanı Almış Hipertansif Hastalarda Platelet Mass İndeksi ile Sabah Kan Basıncı Dalgalanması Arasındaki İlişki

Abstract

Amaç: Bu çalışma, yeni tanı almış hipertansiyon hastalarında Platelet Mass İndeksi (PMI) ile Sabah Kan Basıncı Dalgalanması (SKBD) arasındaki ilişkiyi değerlendirmeyi amaçlamaktadır. Araçlar ve Yöntem: Ocak 2025 ile Nisan 2025 tarihleri arasında bir üçüncü basamak sağlık merkezinin kardiyoloji polikliniğinde yürütülen bu kesitsel çalışmaya, 158 hipertansif ve 191 normotansif birey dahil edilmiştir. Kan basıncı ölçümleri Ayaktan Kan Basıncı İzleme (AKBİ) cihazı ile kaydedilmiş, sabah kan basıncı dalgalanması hesaplanmıştır. Tam kan sayımı parametrelerinden elde edilen Platelet Mass İndeksi, trombosit sayısının ortalama trombosit hacmi (MPV) ile çarpılmasıyla hesaplanmıştır. SKBD’nin öngörülmesinde PMI’nin performansı Alıcı İşletim Karakteristiği (AIK) eğrisi analizi ile değerlendirilmiştir. Bulgular: Hipertansif grupta 24 saatlik, gündüz ve gece sistolik ve diyastolik kan basınçları anlamlı olarak yüksekti (hepsi p<0.001). SKBD, hipertansif bireylerde anlamlı şekilde daha fazlaydı (medyan: 28.2 mmHg; p=0.007). SKBD değeri >28.2 mmHg olan hastalarda trombosit sayısı, PMI, Trombosit-Lenfosit Oranı (PLO) ve nötrofil düzeyleri anlamlı olarak yüksekti (p<0.001). PMI ile PLO arasında güçlü pozitif bir korelasyon gözlenirken (r=0.518, p<0.001), PMI ile gece sistolik kan basıncı arasında zayıf ancak anlamlı negatif bir ilişki saptandı (r=–0.167, p=0.036). AIK analizine göre, PMI’nin SKBD’yi öngörmedeki AUC değeri 0.749 olup, %67.1 duyarlılık ve %67.1 özgüllük ile en yüksek ayırt edici güce sahipti. Sonuç: Platelet Mass İndeksi’nin artmış SKBD ile anlamlı ilişkili olduğu gösterilmiştir. Bulgular, PMI'nin inflamasyon aracılı vasküler stresin bir yansıması olabileceğini ve erken dönemde kardiyovasküler risk belirteci olarak kullanılabileceğini düşündürmektedir.

Keywords

• basınç değişkenliği
• basınç paterni
• sirkadiyen ritim
• trombosit aktivasyonu
• vasküler enflamasyon

The Association Between Platelet Mass Index and Morning Blood Pressure Surge in Newly Diagnosed Hypertensive Patients

Abstract

Purpose: This study aimed to evaluate the relationship between Platelet Mass Index (PMI) and Morning Blood Pressure Surge (MBPS) in patients with newly diagnosed hypertension. Materials and Methods: A cross-sectional study was conducted between January and April 2025 at a tertiary cardiology outpatient clinic, including 158 hypertensive and 191 normotensive individuals. Blood pressure was monitored using Ambulatory Blood Pres-sure Monitoring (ABPM), and MBPS was calculated. PMI was derived by multiplying the platelet count by the mean platelet volume (MPV). The predictive ability of PMI for identifying elevated MBPS was assessed via receiver operating characteristic (ROC) curve analysis. Results: Systolic and diastolic blood pressure values across 24-hour, daytime, and nighttime measurements were significantly higher in the hypertensive group (all p<0.001). MBPS was also significantly increased in hypertensive patients (median: 28.2 mmHg; p=0.007). Patients with MBPS >28.2 mmHg showed significantly higher platelet count, PMI, PLR, and neutrophil levels (p<0.001). PMI was strongly correlated with PLR (r=0.518, p<0.001), and inversely associated with nighttime systolic BP (r=–0.167, p=0.036). ROC analysis revealed that PMI had the highest discriminatory power with an AUC of 0.749, sensitivity of 67.1%, and specificity of 67.1%. Conclusion: PMI was significantly associated with exaggerated MBPS, suggesting that platelet activation may contribute to vascular stress and circadian BP dysregulation. PMI may represent a useful early biomarker for cardiovascular risk stratification in hyperten-sive patients.

Keywords

• blood pressure pattern
• blood pressure variability
• circadian rhythm
• platelet activation
• vascular inflammation

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