Inflammation index SIRI is associated with increased all-cause and cardiovascular mortality among patients with hypertension

Abstract

BackgroundInflammation plays an essential role in the pathogenesis of hypertension. A novel inflammatory biomarker systemic inflammatory response index (SIRI) is related with all-cause and cardiovascular (CVD) mortality, while the role of SIRI in hypertension patients is unclear.MethodsA total of 21,506 participants with hypertension were recruited in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. SIRI was calculated as the neutrophil count * monocyte count/lymphocyte count. Hypertension was defined according to the examination of blood pressure, prescription, and self-reported physician diagnosis. Survival status was followed through 31 December 2019. The non-linear relationship was assessed using restricted cubic spline analysis. The association of all-cause mortality with SIRI was evaluated using the Kaplan–Meier curve and the weighted Cox regression analysis. The predictive abilities were assessed with Receiver operating curve.ResultsDuring 189,063 person-years of follow-up, 5,680 (26.41%) death events were documented, including 1,967 (9.15%) CVD related deaths. A J-shaped association was observed between SIRI and all-cause and CVD mortality. The Kaplan–Meier curve indicated the all-cause and CVD mortality risks were higher in high SIRI quartiles compared with lower SIRI quartiles. After adjusting for all covariates, the SIRI was positively associated with the all-mortality risk with HR = 1.19 (1.15, 1.22), and CVD mortality with HR = 1.19 (1.15, 1.24). The result was robust in subgroup analysis and sensitivity analysis.ConclusionElevated SIRI level is associated with increased all-cause and CVD mortality among patients with hypertension. SIRI is considered as a potential inflammatory biomarker in the clinical practice. Further large-scale cohort studies are required to confirm our findings.

Association of two novel systemic inflammatory biomarkers and frailty based on NHANES 2007–2018

“…Both SII and SIRI are closely correlated with cardiovascular and all-cause mortality. These studies emphasize the role of managing inflammatory markers in frailty among middle-aged and older adults and suggest that emerging biomarkers like SII and SIRI could be powerful tools for assessing and managing the health of middleaged and older individuals (46,47). The findings of this study reveal a positive correlation between SII and SIRI with frailty, especially with SIRI exhibiting a more significant association.…”

System inflammation response index: a novel inflammatory indicator to predict all-cause and cardiovascular disease mortality in the obese population

“…Elevated SIRI levels indicated a positive correlation with the severity of coronary artery disease (CAD) (including three-vessel CAD and acute coronary syndrome) and an increased incidence of myocardial infarction (MI) [ 40 , 41 ]. Zhao et al revealed that each 1-unit increase in continuous SIRI is correlated with a 30% higher hazard of all-cause and CVD mortality in hypertensive patients [ 25 ]. Besides, Cao et al demonstrated that higher SII shows a significant relationship to an increased risk of cardiovascular disease (CVD) mortality in hypertensive patients, and there is a nonlinear association between SII and all-cause mortality [ 27 ].…”

“…The systemic inflammation response index (SIRI) and systemic immune inflammation index (SII), which are composite indices incorporating three distinct subsets of white blood cells and platelets, provide novel insights into the interplay of thrombocytosis, inflammation, and immunity [ 21 – 24 ]. Recently, the associations of increased SIRI and SII levels with the increased risks of all-cause and CVD mortality has been found in the general population and individuals with hypertension [ 21 , 25 – 27 ]. However, the predictive value of SIRI and SII for all-cause and cardiovascular disease mortality in the obese population remains unknown.…”

Association between a metabolic score for insulin resistance and hypertension: results from National Health and Nutrition Examination Survey 2007–2016 analyses

“…In our study, individuals were classified as diabetic based on any of the following: a self-reported diagnosis of diabetes from a doctor or health professional; self-reported use of insulin or diabetic pills; a fasting glucose concentration of ≥7.0 mmol/L; a 2-hour oral glucose tolerance test result of ≥11.1 mmol/L; or a glycohemoglobin HbA1c level of ≥6.5% ( 27 ). Cardiovascular disease (CVD) cases were identified through self-reported physician diagnoses, including congestive heart failure, coronary heart disease, angina, heart attack, or stroke ( 28 , 29 ).…”