Qinghui Zhang,1,* Menglin Wang,1,* Huiyu Du,1 Huiyun Qu,2 Kai Liu,1 Wenyong Dong,1 Dehui Kong,1 Dandan Tian,1 Xiaojian Zhao,1 Yibin Hao,1 Min Liu1 

1Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Henan University, Zhengzhou, Henan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yibin Hao, Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China, Email haoyibin0708@163.com Min Liu, Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China, Email liumin136@126.com

Objective: This study aimed to investigate the relationship between ACI and blood cell-derived inflammatory markers including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) in an essential hypertensive (EH) cohort, and assess the predictive value of these inflammatory markers for ACI risk in this population.
Methods: A total of 583 EH patients were included and categorized into ACI (123 patients) and non-ACI (NACI) (460 patients) groups. Multivariate logistic regression analysis was performed to explore the relationship of PLR, NLR, SII and SIRI to ACI risk in EH population. We also used receiver operating characteristic curve analysis to assess the discriminative ability of four inflammatory markers in predicting ACI risk in EH population.
Results: ACI group exhibited higher levels of inflammatory markers (PLR, NLR, SII, and SIRI) compared to NACI group (P < 0.05). PLR (odds ratio (OR): 1.006, 95% confidence interval (CI): 1.001– 1.011, P = 0.023), NLR (OR: 1.573, 95% CI: 1.225– 2.021, P < 0.001), SII (OR: 1.002, 95% CI: 1.001– 1.003, P < 0.001) and SIRI (OR: 1.851, 95% CI: 1.290– 2.656, P = 0.001) were independent factors for ACI risk in EH patients. The odds ratios of the highest versus lowest quartile of PLR, NLR, SII and SIRI were 2.090 (95% CI 1.085– 4.024), 3.049 (95% CI 1.509– 6.161),2.464 (95% CI 1.278– 4.749) and 3.372 (95% CI 1.709– 6.652), respectively. PLR, NLR, SII, SIRI were characterized by area under the curve (0.586, 0.632, 0.591, 0.617) and cut-off value (125.834, 2.468, 532.011, 0.934), respectively.
Conclusion: The findings suggested that PLR, SII, SIRI, especially NLR were of significant value biomarkers to positively predict ACI risk in EH population.

Keywords: essential hypertension, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, systemic immune inflammation index, systemic inflammation response index, asymptomatic cerebral infarction