Study On The Relationship Between Neutrophil/lymphocyte And Vascular Endothelial Function And Circadian Rhythm Of Blood Pressure In Patients With Hypertension

Objective: By discussing the neutrophil/lymphocyte(neutrophil to lymphocyte ratio,NLR)in essential hypertension patients and healthy people under different NLR level differences,vascular endothelial function in patients with essential hypertension and the difference of blood pressure circadian rhythm and NLR relevance to endothelial function,blood pressure,for the early detection of impaired endothelial function in patients with essential hypertension and blood pressure circadian rhythm disorders provide clues.Methods:From November 2017 to December 2018,200 patients with grade 3 hypertension were selected from the affiliated hospital of Qinghai University.At the same time,205 healthy people who underwent physical examination in our hospital during the same period were collected and set as the control group.All the enrolled patients underwent blood routine and biochemical examination,and flow mediated dilatation(FMD)and ambulatory blood pressuremonitoring(ABPM)were further improved in the case group.According to the NLR level,the grade 3 hypertension group was divided into four groups by quartile method: Q1,Q2,Q3 and Q4.Results:1.The lymphocyte level of grade 3 hypertension group was significantly lower than that of control group(P < 0.05).There was no significant difference between WBC count and neutrophil count(P > 0.05).The NLR level of grade 3 hypertension group was significantly higher than that of control group(P< 0.05).2.There was no significant difference in BMI,HCY,FBG,TC,TG,HDL,LDL between the four groups(P> 0.05).There was no significant difference in medication and complications between groups Q1,Q2,Q3 and Q4(P> 0.05).3.There were significant differences in the levels of FMD between groups Q1,Q2,Q3 and Q4(P< 0.05).Further inter-group comparison showed that there were statistical differences in FMD between group Q1,Q3 and Q4(P< 0.05),and FMD between group Q2 and Q4(P< 0.05).4.There were significant differences in 24h-SBP,d-SBP and n-DBP among Q1,Q2,Q3 and Q4 groups(P < 0.05).Intergroup comparison showed that there was a statistical difference in 24h-SBP between group Q1 and Q3 and Q4(P< 0.05).There was a statistically significant difference in d-SBP between group Q1 and groups Q3 and Q4(P< 0.05).There was a statistically significant difference in d-SBP between Q2 and Q4 groups(P< 0.05).There was a statistically significant difference in n-DBP between group Q1 and Q4(P< 0.05).5.There was no significant difference in the incidence of dipper hypertension and non-dipper hypertension between groups Q1,Q2,Q3 and Q4(P> 0.05).6.The correlation between NLR and FMD,24h-SBP,d-SBP,n-DBP showed that NLR had a moderate negative correlation with FMD(r=-0.406,P=0.000),a weak positive correlation with 24h-SBP(r=0.272,P=0.000)and d-SBP(r=0.295,P=0.000),but no correlation with n-DBP(r=0.179,P=0.011).Conclusion: 1.Increased NLR in patients with grade 3 hypertension suggests an inflammatory response.2.With the gradual increase of NLR level,vascular endothelial function may gradually decrease in patients with grade 3 hypertension.3.The 24-hour mean systolic blood pressure and daytime systolic blood pressure of patients with grade 3 hypertension may gradually increase with the increase of NLR level.4.NLR may not be significant in the disruption of blood pressure circadian rhythm in patients with grade 3 hypertension.