# Association of Inflammatory–Hematological Biomarkers with Hypertension and Related Comorbidities

## TL;DR

This study shows that inflammatory and blood cell markers are linked to hypertension and its related conditions like diabetes and kidney disease.

## Contribution

The study identifies specific blood cell ratios and counts as potential indicators for hypertension and its comorbidities.

## Key findings

- Higher neutrophil counts and lower lymphocyte counts are associated with hypertension and comorbidities.
- NLR and PLR show significant associations in hypertension combined with CKD and T2DM.
- ROC analysis reveals cut-off values for neutrophils, NLR, and PLR in different hypertension-related groups.

## Abstract

Background: According to current data, arterial hypertension (HTN) remains the leading cause of cardiovascular disease worldwide. Oftentimes, HTN is accompanied by type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD), interconnected by a pro-inflammatory pattern. Our study aimed to evaluate the roles of hematological serum cells, such as neutrophils, lymphocytes, and platelets, as well as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in subjects with HTN, CKD, and/or T2DM. Methods: This retrospective unicentric study included 6077 patients admitted between 2018 and 2023; after applying exclusion criteria, patients were divided into groups for a comparative multivariate analysis. Results: The Mann–Whitney U test and the Kruskal–Wallis test showed statistically significant differences between groups. Higher neutrophil counts, lower lymphocyte counts, and platelet fluctuations were positively associated with HTN + comorbidities (p < 0.001 **). Receiver operating characteristic (ROC) analysis identified statistically significant associations for neutrophils and NLR in HTN (AUC = 0.442, p < 0.001 **, cut-off = 1.1217), for lymphocytes in HTN + T2DM (AUC sensitivity of 64.1%, cut-off = 18.950), for NLR (AUC 0.567, sensitivity of 50.6% and a specificity of 61.9% cut-off = 4.4174) and neutrophils (cut-off = 73.550) in HTN + CKD, and for NLR and PLR in HTN + CKD + T2DM (both having reliable AUC; sensitivity 87.9% and 81.8% for cut-off = 2.6957 and 10.5194, respectively). In all groups, AUC specificities were below the acceptable threshold (which considerably diminishes the practical clinical usability potential of these markers). Conclusions: This study demonstrated an association between hematological pro-inflammatory markers and hypertension and its comorbidities.