The relationship between multi-inflammatory index and nondipping circadian pattern in patients with a new diagnosis of essential hypertension

Aim: Previous studies showed that essential hypertension (EHT) had been related to chronic inflammation.A non-dipping circadian blood pressure (BP) pattern confers a greater cardiovascular morbidity and mortality.The multi-inflammatory index (MII) is a novel systemic inflammatory parameter.We aimed to assess the association between MII and the non-dipping BP pattern.Materials and Methods: A total of 158 EHT patients were stratified into nondipper (n=78) and dipper groups (n=80) on the basis of 24h-ambulatory BP monitoring (24h-ABPM).176 healthy subjects were recruited as control group.Data regarding 24h-ABPM, clinical and laboratory findings were collected from the hospital records.MII was calculated as: Neutrophil count C-reactive protein/Lymphocyte count.Results: MII was greater in the non-dippers as compared with the dippers and the controls [5.9(1.21-10.1),3.32(1.34-8.87),and 1.79(0-4.1),respectively, p=0.003].MII was found to show correlation with age (0.200, p=0.011), 24h-systolic BP 0.234, p=0.003), daytime systolic BP (0.192, p=0.016), nighttime systolic BP (0.277, p<0.001), and LVMI (-0.195, p=0.021).In the multivariate logistic regression model, daytime systolic BP p<0.001] and MII [Odd ratio: 1.150(1.029-1.284),p=0.013] were found to be significantly associated with the non-dipping BP pattern.ROC curve analysis revealed a cut-off value of 2.01 with 71.1% sensitivity and 50.4% specificity for MII to predict the nondippers among the EHT patients.Discussion: MII is significantly associated with nondipping circadian BP pattern.MII could be a simple and useful marker to predict the nondippers among the EHT patients.