Monocyte to high density lipoprotein ratio (Mhr) as a risk predictor of resistant hypertension in chronic kidney disease

Background: Resistant hypertension is a condition where blood pressure remains high despite optimal antihypertensive therapy. This condition is often found in patients with chronic kidney disease (CKD). Monocytes and High-density lipoprotein (HDL) each have important roles in the process of inflammation and atherosclerosis. Monocyte to High-Density Lipoprotein Ratio (MHR) has been identified as a risk predictor of resistant hypertension in CKD patients. Objective: Analyzing MHR as a risk predictor of resistant hypertension in CKD patients. Method: This study used a retrospective cross-sectional design with secondary data taken from medical records of patients treated from January 2022 to July 2024. The data taken included monocyte count, HDL levels, and MHR. Subjects consisted of patients with resistant hypertension or hypertension on treatment diagnosed with CKD. Data were analyzed using descriptive statistical tests, Kolmogorov-Smirnov test for data normality, Mann-Whitney test and Kruskal-Wallis test to assess the comparison of median MHR based on gender, adult age group (19-44 years), pre-elderly (45-59 years), elderly (> 60 years) and resistant hypertension status. Results: A total of 49 subjects were analyzed, with baseline data of 81 people before exclusion. The results showed that MHR was higher in patients with resistant hypertension compared to non-resistant hypertension patients, although this difference was not statistically significant (p = >0.05). In addition, there was no significant difference in MHR values based on gender (p = >0.05) and age group (p = >0.05). The study indicated that other factors such as inflammation, oxidative stress, and dyslipidemia may play a greater role in determining MHR in CKD patients with resistant hypertension. Conclusion: MHR has the potential as a predictor of risk factors that can be used in the evaluation and monitoring of resistant hypertension therapy in CKD patients. Further research is recommended to validate the role of MHR in managing resistant hypertension in CKD.