Sistemik İmmün İnflamasyon İndeksi ile Hipertansiyon Tanısı Alan Hastalarda Dipper ve Non-dipper Patern Arasındaki İlişki

Yıl 2024, Cilt: 15 Sayı: 2, 246 - 251, 28.08.2024

Ali Bağcı , Fatih Aksoy

https://doi.org/10.22312/sdusbed.1446067

Öz

Amaç: Hipertansiyon (HT) tüm dünyada yaygın görülen kronik bir hastalıktır ve kardiyovasküler hastalık (KVH) için en yaygın risk faktörüdür. Non-dipper HT, dipper HT ile karşılaştırıldığında artan kalp hastalığı ve hedef organ hasarı riskiyle ilişkilendirilmiştir. Bu çalışmanın amacı, HT tanısı alan hastalarda dipper ve non-dipper patern ile sistemik immün inflamasyon indeksi (SII) arasında ilişki olup olmadığını araştırmaktır.
Materyal ve Metot: Çalışmamız tek merkezli ve retrospektif olarak yürütüldü. 24 saatlik ayaktan kan basıncı takibi (AKBT) yapılan 242 yeni hipertansiyon tanısı alan hastayı içeriyordu. Hastalar HT profillerine göre iki gruba ayrıldı. 94 hastada dipper HT, 123 hastada ise non-dipper HT tespit edildi. SII, trombosit sayısı x nötrofil sayısı / lenfosit sayısı formülü kullanılarak hesaplandı. SII değeri, ilk uygulama sırasında ölçülen hemogram parametreleri kullanılarak hesaplandı. Bu iki grup istatiksel yöntemler ile karşılaştırıldı.
Bulgular: 24 saatlik tansiyon holter takibine göre sırasıyla 94 hastada (%43,5) dipper ve 123 hastada (%56,5) non-dipper hipertansiyon saptandı. Temel klinik ve demografik özellikler değerlendirildiğinde iki grup arasında yaş, cinsiyet dağılımı, vücut kitle indeksi, diyabetes mellitus ve hiperlipidemi olup olmaması açısından istatistiksel olarak anlamlı fark saptanmadı (Tablo.1). SII değeri non-dipper HT grubunda anlamlı olarak yüksekti (sırasıyla 561±263, 758±298, p < 0,001). Tüm parametreler Tablo.3’te verildi.
Sonuç: Bu çalışma, SII'nin, esansiyel hipertansiyonda gece kan basıncındaki yetersiz azalmayı öngörmede yararlı bir belirteç olduğunu gösterdi. Non-dipper hipertansif hastalarda SII değerleri inflamasyonla yakından ilişkilidir. Hipertansiyon hastalarında yüksek SII değeri, non-dipper HT hastalarının belirlenmesinde erken uyarı parametresi olarak kullanılabilir.

Anahtar Kelimeler

Sistemik İmmün İnflamasyon İndeksi, Non-dipper hipertansiyon, Dipper hipertansiyon

Relationship Between Systemic Immune Inflammation Index and Dipper and Non-dipper Pattern in Patients Diagnosed with Hypertension

Öz

Aim: Hypertension (HT) is a chronic disease common worldwide and the most common risk factor for cardiovascular disease (CVD). Non-dipper HT has been associated with an increased risk of heart disease and target organ damage compared with dipper HT. The aim of this study is to investigate whether there is a relationship between dipper and non-dipper patterns and systemic immune inflammation index (SII) in patients diagnosed with HT.
Materials and Methods: Our study was conducted single-center and retrospectively. It included 242 patients newly diagnosed with hypertension who underwent 24-hour ambulatory blood pressure monitoring (ABPM). The patients were divided into two groups according to their HT profiles. Dipper HT was detected in 94 patients and non-dipper HT was detected in 123 patients. SII was calculated using the formula platelet count x neutrophil count / lymphocyte count. The SII value was calculated using the hemogram parameters measured during the first application. These two groups were compared using statistical methods.
Results: According to 24-hour blood pressure holter monitoring, dipper hypertension and non-dipper hypertension were detected in 94 patients (43.5%) and 123 patients (56.5%), respectively. When basic clinical and demographic characteristics were evaluated, no statistically significant difference was found between the two groups in terms of age, gender distribution, body mass index, diabetes mellitus and hyperlipidemia (Table.1). SII value was significantly higher in the non-dipper HT group (561±263, 758±298, p < 0.001, respectively). All parameters are given in Table.3.
Conclusion: This study showed that SII is a useful marker in predicting inadequate nocturnal blood pressure reduction in essential hypertension. SII values are closely related to inflammation in non-dipper hypertensive patients. High SII value in hypertension patients can be used as an early warning parameter in identifying non-dipper HT patients.

Anahtar Kelimeler

Systemic Immune Inflammation Index, Non-dipper Hypertension, Dipper Hypertension

Kaynakça

• [1] Stanaway JD, Afshin A, Gakidou E, Lim SS, Abate D, Abate KH, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018;392(10159):1923-94.
• [2] Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European heart journal. 2018;39(33):3021-104.
• [3] Fukuda M, Munemura M, Usami T, Nakao N, Takeuchi O, Kamiya Y, et al. Nocturnal blood pressure is elevated with natriuresis and proteinuria as renal function deteriorates in nephropathy. Kidney international. 2004;65(2):621-5.
• [4] Seo H-S, Kang TS, Park S, Choi EY, Ko Y-G, Choi D, et al. Non-dippers are associated with adverse cardiac remodeling and dysfunction (R1). International journal of cardiology. 2006;112(2):171-7.
• [5] Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. International archives of medicine. 2012;5(1):1-6.
• [6] Bağcı A, Aksoy F. Systemic immune–inflammation index predicts new-onset atrial fibrillation after ST elevation myocardial infarction. Biomarkers in Medicine. 2021;15(10):731-9.
• [7] Erdoğan M, Erdöl MA, Öztürk S, Durmaz T. Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis. Biomarkers in medicine. 2020;14(16):1553-61.
• [8] Hu B, Yang X-R, Xu Y, Sun Y-F, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clinical Cancer Research. 2014;20(23):6212-22.
• [9] Association WM. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Jama. 2013;310(20):2191-4.
• [10] Mancia G, Parati G. The role of blood pressure variability in end-organ damage. Journal of hypertension. 2003;21:S17-S23.
• [11] Kanbay M, Turkmen K, Ecder T, Covic A. Ambulatory blood pressure monitoring: from old concepts to novel insights. International urology and nephrology. 2012;44:173-82.
• [12] Verdecchia P, Porcellati C, Schillaci G, Borgioni C, Ciucci A, Battistelli M, et al. Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. hypertension. 1994;24(6):793-801.
• [13] De La Sierra A, Redon J, Banegas JR, Segura J, Parati G, Gorostidi M, et al. Prevalence and factors associated with circadian blood pressure patterns in hypertensive patients. Hypertension. 2009;53(3):466-72.
• [14] Kaya MG, Yarlioglues M, Gunebakmaz O, Gunturk E, Inanc T, Dogan A, et al. Platelet activation and inflammatory response in patients with non-dipper hypertension. Atherosclerosis. 2010;209(1):278-82.
• [15] Ermis N, Yagmur J, Acikgoz N, Cansel M, Cuglan B, Pekdemir H, et al. Serum gamma-glutamyl transferase (GGT) levels and inflammatory activity in patients with non-dipper hypertension. Clinical and Experimental Hypertension. 2012;34(5):311-5.
• [16] Hermida RC, Ayala DE, Mojón A, Fernández JR. Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level—the “normotensive non-dipper” paradox. Chronobiology international. 2013;30(1-2):87-98.
• [17] Kim S, Kim N-H, Kim YK, Yoo JH, Shin SN, Ko JS, et al. The number of endothelial progenitor cells is decreased in patients with non-dipper hypertension. Korean Circulation Journal. 2012;42(5):329-34.
• [18] Lee S, Choe J-W, Kim H-K, Sung J. High-sensitivity C-reactive protein and cancer. Journal of epidemiology. 2011;21(3):161-8.
• [19] Torun D, Ozelsancak R, Yiğit F, Micozkadıoğlu H. Increased inflammatory markers are associated with obesity and not with target organ damage in newly diagnosed untreated essential hypertensive patients. Clinical and Experimental Hypertension. 2012;34(3):171-5.
• [20] Bağcı A, Aksoy F, Baş HA. Systemic immune-inflammation index may predict the development of contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction. Angiology. 2022;73(3):218-24.
• [21] Çırakoğlu ÖF, Yılmaz AS. Systemic immune-inflammation index is associated with increased carotid intima-media thickness in hypertensive patients. Clinical and Experimental Hypertension. 2021;43(6):565-71.