Systemic inflammation response index is independently associated with mitral and tricuspid regurgitation in hypertensive patients: a large cross-sectional study

Inflammation plays an important role in the pathophysiology of hypertension, partly through immune activation and endothelial dysfunction. Therefore, this study aimed to investigate the association between the Systemic Inflammation Response Index (SIRI) and the presence of overall valvular insufficiency and its subtypes (mitral and tricuspid regurgitation), among individuals with hypertension. This cross-sectional study included 35,621 patients with hypertension. Multivariable logistic regression models were used to evaluate the associations between SIRI levels and the presence of overall valvular insufficiency and its subtypes (mitral and tricuspid regurgitation), after adjustment for potential confounders. Restricted cubic spline analysis was performed to characterize the shape of the associations between continuous SIRI levels and the study outcomes. Subgroup and sensitivity analyses were conducted to assess the robustness of the findings. Finally, the incremental discriminative value of adding SIRI to a conventional clinical model was evaluated using the area under the receiver operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Multivariate logistic regression shows that there is a significant positive correlation between elevated SIRI and the prevalence of overall valvular insufficiency and its subtypes. From a quantitative perspective, for every additional standard deviation of SIRI, the odds of overall valvular insufficiency increases by 25% (odds ratio [OR]: 1.25, 95% confidence interval [CI]: 1.21–1.30, P < 0.001). In addition, the RCS analysis shows that there is a positive linear relationship between the SIRI level and the outcome. These patterns are consistent in all subtypes, especially in mitral and tricuspid regurgitation. Subgroup analysis shows that these associations are independent of hierarchical variables, and sensitivity analysis once again confirms its robustness. Finally, the inclusion of SIRI in the baseline model significantly enhances its ability to distinguish and reclassify the accuracy of overall valve insufficiency and its subtypes, which is reflected in the significant improvement of AUC, NRI, and IDI. As a composite marker of systemic inflammation, higher SIRI levels were independently associated with a higher prevalence of overall valvular insufficiency and its subtypes (mitral and tricuspid regurgitation), among patients with hypertension.