Cennet YILDIZ, Abdülmelik YILDIZ, Yılmaz GÜNEŞ

Red Blood Cell Distribution Width, Mean Platelet Volume and Neutrophil/Lymphocyte Ratio in 'Non-Dippers' Versus 'Dippers'

Amaç: Çalışmamızın amacı dipper ve non - dipper hipertansif hastalarda eritrosit dağılım genişliği (EDG), ortalama trombosit hacmi (OTH) ve nötrofil/lenfosit oranını (NLO) karşılaştırmaktı r. Gereç Yöntem: Çalışmaya kardiyoloji polikliniğinde takibi yapılan 116 hipertansif hasta dahil edildi. 24 saatlik ambulatuvar kan basıncı (K B) monitörizasyonuna göre hastalar dipper ve non - dipper olmak üzere iki gruba ayrıldı. Tüm hastalara biyokimyasal testler ve tam kan sayımı yapıldı. Bulgular : Hastaların 54'ü dipper (ortalama yaş; 54.7 ± 13.6), 62'si non - dipper (ortalama yaş; 59.7±12.6) gruptaydı. Her iki grubun gündüz KB ölçümleri arasında anlamlı fark yoktu. Dipper KB profili olan hastaların non - dipper olanlara göre gece ortalama sistolik (116±11.4 ve 127.7±12.7 mmHg p

Dipper" ve "Non-dipper" Hipertansif Hastalarda Eritrosit Dağılım Genişliği, Ortalama Trombosit Hacmi ve Nötrofil/Lenfosit Oran

Objective: The aim of this study is to compare red blood cell distribution width (RDW) , mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) in dipper and non-dipper hypertensive patients. Material and Method: A total of one hundred and sixteen patients were included in our study. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) were performed for each patient. There after patients were divided into two groups: 54 dipper hypertensives (mean age; 54.7 ± 13.6) and 62 non-dipper hypertensives (mean age; 59.7±12.6). Complete blood count and biochemistry were performed in all subjects. Results: Daytime systolic and diastolic blood pressure (BP) measurements were similar between dippers and non-dippers, but night-time measurements were significantly different (night-time systolic BP: 127.7±12.7 vs 116±11.4 mmHg, p<0.0001; night-time diastolic BP: 78.6±9.0 vs 72.4±8.5 mmHg, p<0.0001). Non-dippers had significantly higher RDW levels than dippers (14.5±1.3 vs 13.8±1.2 p =0.005). Non-dipper patients demonstrated higher levels of MPV and NLR compared with dippers (9.5±1.1 vs 8.9±1.0 fL p=0.05 and 2.7±1.1 vs 2.1±0.7 p<0.001). There was significant negative correlation between percentage decline of systolic and diastolic BP from day to night and RDW (r = - 0.2 p <0.025 and r = - 0.3 p Conclusion: Our results suggest that RDW, MPV and NLR levels, which are indicators of platelet activation and inflammatory response are significantly higher in non-dippler hypertensive patients compared to dipper hyperensives

PDF

___

MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias Lancet 1990; 335: 765-774.
Chobanian AV, Bakris GL, Black HR, et al. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatmet of High Blood Pressure. The JNC 7 Report. JAMA 2003; 289: 2560-2572.
Cuspidi C, Meani S, Salerno M, et al. Cardiovascular target organ damage in essential hypertensives with or without reproducible nocturnal fall in blood pressure. J Hypertens 2004; 22: 273-280.
Della Mea P, Lupia M, Bandolin V, et al. Adiponectin, insulin resistance, and left ventricular structure in dipper and nondipper essential hypertensive patients. Am J Hypertens 2005; 18: 30- 35.
Higashi Y, Nakagawa K, Kimura M, et al. Circadian variation of blood pressure and endothelial function in patients with essential hypertension: a comparison of dippers and non- dippers. J Am Coll Cardiol 2002; 40: 2039-2043.
Kaya MG, Yarlioglues M, Gunebakmaz O, et al. Platelet activation and inflammatory response in patients with non- dipper hypertension Atherosclorosis 2010; 209: 278-282.
Sega R, Facchetti R, Bombelli M, et al. Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation 2005; 111: 1777-1783.
Staesesen JA, Thijs L, Fagard R, et al. Predicting cardiovascular risk using conventional vs. ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. JAMA 1999; 282: 539-546.
Fagard RH, Thijs L, Staessen JA, Clement DL, De Buyzere ML, De Bacquer DA. Night-day blood pressure ratio and dipping pattern as predictors of death and cardiovascular events in hypertension. J Hum Hypertens 2009; 23: 645-653.
Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. for the Cholesterol and Recurrent Events (CARE) Trial Investigators. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 2008; 117: 163-168.
Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009; 169: 515- 523.
Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med 1991; 9: 71-74.
Tsuboi S, Miyauchi K, Kasai T, et al. Impact of Red Blood Cell Distribution Width on Long-Term Mortality in Diabetic Patients After Percutaneous Coronary Intervention. Circ J 2013; 77: 456- 461.
Tanindi A, Topal FE, Topal F, Celik B. Red cell distribution width in patients with prehypertension and hypertension. Blood Press 2012; 21: 177-181.
Gunebakmaz O, Kaya MG, Duran M, Akpek M, Elcik D, Eryol NK. Red blood cell distribution width in 'non-dippers' versus 'dippers'. Cardiology 2012; 123: 154-159.
Ozcan F, Turak O, Durak A, et al. Red cell distribution width and inflammation in patients with non-dipper hypertension. Blood Pres 2013; 22: 80-85.
Boos CJ, Balakrishnan B, Lip GY. The effects of coronary artery disease severity on time-dependent changes in platelet activation Thrombolysis 2008; 25: 135-140. whole blood. J Thromb
Mathur A, Robinson MS, Cotton J, Martin JF, Erusalimsky JD. Platelet reactivity in acute coronary syndromes: evidence for differences in platelet behaviour between unstable angina and myocardial infarction. Thromb Haemost 2001; 85: 989-994.
Pizzulli L, Yang A, Martin JF, Luderitz B. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J 1998; 19: 8084.
Yilmaz MB, Cihan G, Guray Y, et al. Role of mean platelet volume in triagging acute coronary syndromes. J Thromb Thrombolysis 2008; 26: 49-54
Yildiz A, Tekiner F, Karakurt A, Sirin G, Duman D. Preprocedural red blood cell distribution width predicts bare metal stent restenosis. Coron Artery Dis 2014; 25: 469-73.
Varol E, Akcay S, Icli A, Ozkan E, Erdogan D, Ozaydin M. Mean platelet volume in patients with prehypertension and hypertension. Clin Hemorrheol Microcirc 2010; 45: 67-72.
Inanc T, Kaya MG, Yarlioglues M, et al. The mean platelet volume in patients with non-dipper hypertension compared to dippers and normotensives. Blood Pres 2010; 19: 81-85.
Sunbul M, Gerin F, Durmus E, et al. Clin Exp Hypertens Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens 2014; 36: 217-2.
Sabatine MS, Morrow DA, Cannon CP, et al. Relationship between baseline white blood cell count and degree of coronary artery disease and mortality in patients with acute coronary syndromes: a TACTICSTIMI 18 (treat angina with aggrastat and determine cost of therapy with an invasive or conservative strategy-trombolysis myocardial infarction 18) substudy. J Am Coll Cardiol 2002; 40: 1761- 1768.
Tatsukawa Y, Hsu WL, Yamada M, et al. White blood cell count, especially neutrophil count, as a predictor of hypertension in a Japanese population. Hypertens Res 2008; 31: 1391-1397.
Nakanishi N, Sato M, Shirai K, Suzuki K, Tatara K. White blood cell coutn as a risk factor for hypertension: a study of Jamanese male Office workers J Hypertens 2002; 20: 851-857.
Vasunta RL, Kesäniemi YA, Ylitalo A, Ukkola O. Nondipping pattern and carotid atherosclerosis in a middle-aged population: OPERA Study Am J Hypertens 2012; 25: 60-66.