Epicardial Fat Thickness and Neutrophil to Lymphocyte Ratio are Increased in Non-Dipper Hypertensive Patients

Abstract

BackgroundIn this study, we aimed to investigate the relationship between echocardiographic epicardial fat thickness (EFT), neutrophil to lymphocyte ratio (NLR; an important inflammatory marker), and diurnal blood pressure (BP) changes in patients with recently diagnosed essential hypertension.MethodsA total of 647 patients underwent echocardiography and 24 hours of ambulatory BP monitoring. EFT was measured by echocardiography, while NLR was measured by dividing the neutrophil count by the lymphocyte count. Patients were categorized into three groups according to BP pattern: the normotensive group, the dipper group, and the non-dipper group.ResultsThe mean EFT was highest in the non-dipper group (non-dipper group, 7.3 ± 3.0 mm; dipper group, 6.1 ± 2.0 mm; control group, 5.6 ± 2.0 mm; p < 0.001). NLR was also highest in the non-dipper group (non-dipper, 2.75 ± 2.81; dipper, 2.01 ± 1.32; control, 1.92 ± 1.11; p < 0.001). EFT was significantly correlated with age (r = 0.160, p < 0.001) and NLR (r = 0.353, p < 0.001). Furthermore, an EFT ≥ 7.0 mm was associated with the non-dipper BP pattern with 51.3% sensitivity and 71.6% specificity [95% confidence interval (CI) = 0.56–0.65, p < 0.001]. In a multivariate analysis, EFT [adjusted odds ratio (OR) = 3.99, 95% CI = 1.22–13.10, p = 0.022] and NLR (OR = 1.34, 95% CI = 1.05–1.71, p = 0.018) were independent parameters that distinguished a non-dipper pattern after adjustment for cardiovascular risk factors.ConclusionEFT and NLR are independently associated with impaired diurnal BP profiles in hypertensive individuals. EFT (as measured by echocardiography) and NLR appear to be helpful in stratifying cardiometabolic risk.

An Important Question That Needs to Be Proved: Is There Any Relationship between the Epicardial Fat Thickness and the Coronary Artery Complexity in Patients with Acute Non-ST Elevation Myocardial Infarction?

“…Ozcicek et al (39) showed that NLR levels were independently associated with EFT in patients with end-stage renal disease receiving hemodialysis. Another study found that NLR and EFT were increased in non-dipper hypertensive patients and they were significantly correlated with each other (40). In the present study, although patients with more complex CAD had significantly higher levels of NLR, we did not find any correlation between NLR and EFT.…”

Pretreatment combination of platelet counts and neutrophil&ndash;lymphocyte ratio predicts survival of nasopharyngeal cancer patients receiving intensity-modulated radiotherapy

“…Still another limitation is that because we did not take serial blood samplings during and after treatment period, we could not determine whether COP-NLR’s interval changes predicted treatment response and survival or establish its possible role in post-treatment surveillance. In addition, it is worth noting that, although blood parameters are of clinical value in predicting disease severities of the associated complications of common disorders such as diabetes mellitus 37 and hypertension, 38 we did not exclude patients with these comorbid conditions as our sample size was already limited and we lacked detailed information regarding their disease severity. Nonetheless, the confounding impact of these comorbidities should be minimized as CCIS was one of risks we factored into our survival analysis.…”

Fibrosis-4 index: A new marker to predict non-dipper blood pressure pattern in patients with newly diagnosed hypertension

“…In another recent study, it was shown that local EFT may play a role in the pathogenesis of ventricular arrhythmias originating from the right ventricular outflow tract [23,24]. EFT was associated with abnormal diurnal BP patterns [25]. As can be observed, EFT is associated with many clinical cardiovascular conditions.…”