Epicardial Fat Thickness and Neutrophil to Lymphocyte Ratio are Increased in Non-Dipper Hypertensive Patients.
10.4250/jcu.2016.24.4.294
- Author:
Bong Joon KIM
1
;
Kyoung Im CHO
;
Ji Hun CHOI
;
Dong Hyun PARK
;
Ga In YU
;
Sung Il IM
;
Hyun Su KIM
;
Jeong Ho HEO
;
Tae Joon CHA
Author Information
1. Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea. kyoungim74@gmail.com
- Publication Type:Original Article
- Keywords:
Epicardial fat thickness;
Neutrophil to lymphocyte ratio;
Hypertension;
Non-dipper
- MeSH:
Blood Pressure;
Echocardiography;
Humans;
Hypertension;
Lymphocyte Count;
Lymphocytes*;
Multivariate Analysis;
Neutrophils*;
Odds Ratio;
Risk Factors;
Sensitivity and Specificity
- From:Journal of Cardiovascular Ultrasound
2016;24(4):294-302
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: In 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. METHODS: A 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. RESULTS: The 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. CONCLUSION: EFT 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.
