Association of white blood cell counts with left ventricular mass index in hypertensive patients undergoing anti-hypertensive drug therapy

Abstract

Although studies using animal models have demonstrated that nonhemodynamic factors, including inflammatory cells and cytokines, contribute to left ventricular hypertrophy (LVH), there is little clinical data to confirm this association. Therefore in the present study, levels of circulating specific types of leukocyte were measured to determine the association between white blood cells and left ventricular mass index (LVMI) in hypertensive patients undergoing anti-hypertensive drug therapy. A total of 144 consecutive hypertensive patients taking anti-hypertensive drug therapy were enrolled in the current study. Subjects were divided into two groups: Those with normal geometry and those with left LVH. Total white blood cells and differentiated subtypes (neutrophils, lymphocytes, monocytes) were counted, and left ventricular end-diastolic diameter, left ventricular posterior wall thickness in diastole and inter-ventricular septal wall thickness in diastole were all measured. Analysis revealed a significant correlation between LVMI and total white blood cell levels (P=0.013). The percentage of LVH in the highest tertile of WBC was increased compared with the middle tertile (P=0.008). Furthermore, a significant correlation between the highest tertile of neutrophil counts and LVH was observed (P=0.039). However, no significant associations between LVMI and monocyte or lymphocyte counts were detected. Therefore, the current study determined that increased total white blood cell and neutrophil subtype counts were associated with LVMI in hypertensive patients undergoing anti-hypertensive drug therapy. They may provide convenient and useful markers for further risk appraisal of LVH caused by nonhemodynamic factors of hypertension.

Neutrophil to Lymphocyte Ratio as a Predictor of Left Ventricular Hypertrophy in Patients with Newly Diagnosed Hypertension

“…obesity, body size, insulin, and the renin-angiotensin system contribute to LVH development [18]. Also, nonhemodynamic factors, including transforming growth factor β1, tumor necrosis factor-alpha (TNF-a), and cytokines plays an important role in LV remodelling [19,20].…”

“…In recent years, many studies have investigated the relationship between NLR, HT, and LVMI. Shi, et al [20] demonstrated that a strong correlation between WBC counts (particularly neutrophil counts) and LVMI in hypertensive patients currently taking anti-hypertensive medication. Our findings are consistent with this study results, and we showed that NLR was positively correlated whit LVH in CH and EH groups.…”

Pathogenesis of hematological parameters in hypertension

“…However, the NHANES I Epidemiological Follow-up Study (NHEFS) reported an association between higher WBC count and increased incidence of hypertension in white men, and possibly in older white and black women [35]. In a study conducted by Shi et al [36], it was found that certain types of circulating leukocytes in hypertensive patients using antihypertensive medications might be linked to left ventricular hypertrophy (LVH).…”