Neutrophil-to-lymphocyte ratio in patients with white-coat hypertension

Abstract

Introduction: White coat hypertension (WCH), a distinct phenotype of hypertension, is defined as elevated office blood pressure (BP) measurements during repeat visits with normal out-of-office BP measurements. The association of WCH with cardiovascular risk remains unclear; however, current data support an association between untreated WCH and the risk for cardiovascular events, cardiovascular mortality, and all-cause mortality. Increased inflammatory processes may explain the underlying pathophysiology of the increased risk for cardiovascular events in WCH; therefore, we evaluated the neutrophil-to-lymphocyte ratio (NLR) of patients with WCH compared with matched normotensive controls. Material and Method: Forty-five eligible subjects with WCH and 45 age, sex, and BMI matched healthy and normotensive subjects were included in the study. The subjects were assessed by office arterial BP and 24-hour ambulatory BP measurements. An automated blood count analyzer measured the NLR values. Results: The mean NLR in the patients-with-WCH group was significantly higher than that in the control group (2.67±0.27 vs. 2.46±0.34, p<0.001, Student’s t-test); however, NLR was not correlated with BP measurements in either the WCH or control group. Conclusion: NLR, a marker of inflammation, was increased in patients with WCH compared to the controls. Inflammation is a triggering mechanism for various cardiovascular and cerebrovascular events. Therefore, NLR has value as a potential independent risk factor that deserves further study, particularly in patients with WCH.

Keywords

• high blood pressure
• systemic hypertension
• inflammation
• neutrophil-to-lymphocyte ratio
• white coat hypertension

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