The relationship between carotid i̇nti̇ma-media thickness, aortic stiffness and neutrophil-lymphocyte ratio in patients with prehypertension

Introduction and Objective: Prehypertensive patients have a more increased overt cardiovascular risk when compared to normotensive ones. In prehypertensive patients, the increased cardiovascular risk can be avoided by preventing the overt/apparent development/emergence of hypertension. The prehypertensive patient population comprises a larger group of patients in comparison to the one discussed in the previously conducted studies, and it is possible to be of the opinion that the study in question will be of more use to the population in this respect. Establishing the diagnosis of prehypertension allows for understanding the risk of a lifetime development of hypertension within the society and for minimizing the cardiovascular complications. Apart from the fact that the development of the disease is multifactorial, atherosclerosis and inflammation are the major known causes of the disease. It is possible to understand the severity of the disease by taking into consideration the elastic properties of the aorta, the carotid artery intima-media thickness (CIMT) and the neutrophil lymphocyte ratio (NLR) , a new determinant for inflammation. Material and Method Selected from the general population of the city of Malatya, a total of 100 patients, 50 of whom were female prehypertensive patients whose blood pressure ranged between 120/80 mmHg and 139/89 mmHg and 50 of whom were normotensive patients with blood pressure below 120/80 mmHg, were incorporated in the study. The detailed history of all the individuals involved in this study were received, and their physical examinations were also performed. Their blood pressures were measured from both arms, and the follow-up measurements were performed on the arm with the highest BP. The systolic blood pressure, diastolic blood pressure, pulse pressure, the average/mean BP and heart rates were taken down.The systolic and diastolic diameters of the aorta to calculate echocardiographically the elastic properties of the aorta ( aortic distensibility, aortic stiffness, aortic strain) were measured. Separately, the LVSÇ, LVDÇ, IVS, PW, EDV, ESV, E, A, E/A, and EF measurements of all the patients were made. KIMK was measured via ultrasonography. The complete blood count (CBC) was performed. The number of neutrophiles and lymphocytes along with the NLR were calculated according to the result obtained from these measurements. Findings: No statistically significant difference was determined in terms of the demographic characteristics between both of the groups. The mean age in the prehypertensive patient population was 41,76±12,28, whereas in the normotensive population, it was determined as 41,6±12,02. All the patients were female. The aortic stiffness index was determined as 4,14±0,21 in the prehypertensive population and as 3,94±0,26 in the normotensive one. The KIMK in the prehypertensive population was calculated as 0,73±0,097, while in the normotensive one, it was 0,55±0,065. Another parameter, NLR was 2,94±0,45 in the prehypertensive population and 2,44±0,27 in the normotensive one. The correlation among the aortic stiffness, CIMT and NLR, despite being positive, proved to be insignificant. It was concluded that when the separate populations were evaluated within themselves, there was a positive correlation among creatinine, glucose, cholesterol and BMI along with these 3 parameters; however, this was found to be statistically insignificant. Result: The result we acquired in our study where we compared the prehypertensive patients with the normotensive ones in terms of their aortic stiffness, CIMT and NLR suggested that with the development of prehypertension in the patients, the severity of the disease and its relevance with the increased blood pressure (BP) needed to be determined through echocardiographic, ultrasonographic and biochemical measurements and the development of overt hypertension required to be prevented through early diagnosis.