Assessment of Mean Platelet Volume in Patients with Resistant Hypertension, Controlled Hypertension and Normotensives

The Predictive Role of Hematological Parameters in Hypertension

Hypertension (HT) is a common chronic disease that often causes target-organ damage and severe complications, contributing to cardiovascular morbidity and mortality worldwide. Accumulating evidence suggests that inflammation plays a prominent role in the initiation and progression of HT. Multiple inflammatory biomarkers have been proposed to predict HT. Several new hematological parameters can reflect the inflammatory response and platelet activation. The major advantage of hematological parameters over conventional inflammatory markers is that they are relatively inexpensive and easily obtained from routine blood tests. Numerous studies have investigated several hematological parameters for their utility as predictive biomarkers for the diagnosis and prognosis of HT. Among them, the neutrophil to lymphocyte ratio (NLR), monocyte to high density lipoprotein cholesterol ratio (MHR), red cell distribution width (RDW), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), platelet distribution width (PDW), and systemic immune-inflammation index (SII) have recently received attention. We searched PubMed and Embase databases (up to September 18, 2022) to assess the relationships between hematological parameters and HT. This review discusses the diagnostic and prognostic value of these hematological parameters in HT, providing an important basis for early screening, risk stratification, and optimal management of hypertensive patients.

Mean Platelet Volume/Platelet Count Ratio and Dipper/Non-Dipper Hypertensive Patients

There is an interaction between mean platelet volume (MPV), platelet count (PC), inflammation, and platelet reactivity. The present study evaluated the relationship between the MPV/PC ratio and blood pressure (BP) using 24 h ambulatory BP monitoring (ABPM). A total of 720 patients (male: 291) were included in the study. Based on the ABPM outcomes, they were divided into two groups: dipper hypertensive (n = 350; male: 136) and non-dipper hypertensive (n = 370; male: 155). Peripheral venous blood samples obtained at admission were used for PC and MPV calculations. Both groups displayed identical clinical characteristics. Non-dipper hypertensives had a higher MPV/PC ratio than dipper hypertensives [0.044; (0.036-0.055); 0.036 (0.030-0.042); P < .001]. According to receiver operating characteristic (ROC) curve analysis, the optimal cut-off value of the MPV/PC ratio for predicting non-dipper patterns in hypertensive patients was 0.040 (area under the curve [AUC]: 0.726, P < .001). Sensitivity was 64.1% and specificity was 64.3%. The MPV/PC ratio may represent mechanisms involved in increasing cardiovascular risk in non-dipper hypertensives compared with dipper hypertensives.

Evaluation of Mean Platelet Volume in Children with Hypertension

Background

Childhood hypertension, a disease with increasing prevalence, can lead to severe health problems. With the increased pressure on the vascular endothelium in hypertension, lesions in the endothelium result in endothelial activation and a process of inflammation, which causes platelet activation and in the bone marrow the release of platelet precursor cells into the peripheral blood stream. During inflammation, changes in the number and size of platelets are observed. With the release of platelet precursors into the peripheral blood stream due to platelet activation, an increase in mean platelet volume (MPV) is also seen.

Aim

Our aim in this study is the evaluation of MPV changes in the hemogram of children suffering from hypertension, a condition causing severe cardiovascular problems. Material and Methods. This research is a descriptive retrospective cross-sectional study. It consists of a patient group diagnosed with hypertension and a control group of children presenting for routine check-ups with no diagnosed hypertension. Demographic characteristics, arterial pressure values, and hemogram parameters have been evaluated.

Results

A total of 90 cases were enrolled in the study, including a patient group of 45 cases with hypertension (19 females, 26 males) and a control group of 45 cases (27 females, 18 males). The median age was 15 years in the hypertension group and 13 years in the control group. In the hypertension cases, the thickness of the carotis intima media was statistically significantly greater than in the control group (p < 0.001). Echocardiographic findings (IVSd, LVDd, LVPWd, IVSs, LVDs, LVPWs, and LV mass) were significantly higher in the hypertension group compared to the control group (p < 0.001). A statistically significant difference in platelet count and MPV values between the groups was not found (p = 0.151, p = 0.405, respectively).

Conclusion

While MPV is hypothesized to be higher in hypertensive individuals, there was no statistically significant difference between the hypertensive and non-hypertensive groups in this study.

Components of the Complete Blood Count as a Risk Predictor for Incident Hypertension in a Large Taiwanese Population Follow-up Study

BACKGROUND

Previous studies investigating the relationship between hypertension (HT) and hematological parameters report inconsistent results, and most them included a small number of participants or only conducted a cross-sectional analysis of 1 or 2 hematological factors. Moreover, no large cohort follow-up studies have investigated this topic. The aim of this longitudinal study was to explore associations between components of the complete blood count (CBC) and incident HT using data from a large Taiwanese biobank.

METHODS AND RESULTS

Hematological parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin, hematocrit (HCT), and platelet count were evaluated. We included 21,293 participants who did not have HT at baseline and followed them for a mean period of 3.9 years. During follow-up, 3,002 participants with new-onset HT (defined as incident HT) were identified. Univariable analysis revealed that high WBC count, high RBC count, high hemoglobin, high HCT, and low platelet count were associated with incident HT. Multivariable analysis after adjusting potential confounding factors found high WBC count (odds ratio [OR], 1.057; 95% confidence interval [CI], 1.028 to 1.087; P<0.001) and high HCT (OR, 1.023; 95% CI, 1.010 to 1.036; P<0.001) were still significantly associated with incident HT.

CONCLUSIONS

High WBC count and high HCT were associated with incident HT.

No obvious association exists between mean platelet volume and hypertension subtypes

Aims: To determine the association between mean platelet volume (MPV) and hypertension subtypes. Participants & results: 44,281 Chinese individuals were enrolled in this cross-sectional study. The mean blood pressure decreased with increasing MPV in females (p = 0.001) and increased MPV seemed to be a potential protective factor for isolated diastolic hypertension in models 1 and 2. The OR (CI) was 0.878 (0.789-0.976) for model 1 and 0.880 (0.789-0.981) for model 2 in males and 0.646 (0.495-0.841) for model 1 and 0.657 (0.503-0.858) for model 2 in females, when MPV was analyzed as a categorical variable. The OR (CI) was 0.947 (0.911-0.985) for Model 1 and 0.947 (0.910-0.985) for Model 2 in males, and 0.886 (0.807-0.973) for Model 1 and 0.892 (0.813-0.978) for Model 2 in females when MPV was analyzed as a continuous variable. However, the statistical difference of OR disappeared when we added blood-related covariates in Model 3. Conclusion: No obvious association exists between MPV and hypertension subtypes. Other blood parameters might have a greater impact on hypertension subtypes.

Association of the mean platelet volume and red cell distribution width with dipper and non-dipper blood pressure in prehypertensive non-smokers

OBJECTIVE

Absence of nocturnal blood pressure (BP) dipping is associated with poor health outcomes, including increased mortality. Non-dipper BP seems to be a predictor of cardiovascular damage in hypertensive patients. The aim of this study was to investigate the association of the mean platelet volume (MPV) and red cell distribution width (RDW) with nocturnal dipping/non dipping status in newly diagnosed and untreated prehypertensive non-smokers, using ambulatory BP monitoring.

RESULTS

Twenty-eight patients (15 males) in the dipper group and 24 patients (11 males) in the non-dipper group were evaluated in this study. The age of patients was 41.64 ± 15.01 and 37.96 ± 15.08 years in the dipper and non-dipper groups, respectively. The rate of nocturnal systolic BP drop in the dipper and non-dipper groups was 13.79 ± 3.35% (10.20-22.10) and 5.96 ± 2.87% (1.10-9.30) (P < 0.001), respectively. Also, the mean rate of nocturnal diastolic BP drop in the dipper and non-dipper groups was 17.02 ± 5.09% (10.30-26.90) and 6.19 ± 2.75% (1.20-9.70) (P < 0.001), respectively. RDW and MPV were significantly higher in non-dipper patients than dipper patients (P = 0.001 and P = 0.012, respectively). Bivariate analysis revealed that MPV was inversely correlated with the nocturnal systolic BP drop (P = 0.005, r = - 0.385). Furthermore, RDW was inversely correlated with systolic BP drop (P = 0.019, r = - 0.324).

The Effect of Mean Platelet Volume/Platelet Count Ratio on Dipper and Non-Dipper Blood Pressure Status

Background and Objectives: The mean platelet volume (MPV) represents a possible marker of platelet activation. There is an association between the platelet count (PC) and inflammation and platelet reactivity. We assessed the association between the MPV/PC ratio and circadian alterations in blood pressure (BP). Material and Methods: One hundred and twenty subjects in total, 80 hypertensive subjects and 40 healthy subjects (controls), were enrolled in the study group. Twenty four hour ambulatory BP monitoring (ABPM) was applied to all subjects. According to ABPM results, the hypertensive subjects were separated into two groups, such as dippers (n = 40) and non-dippers (n = 40). In all subjects, the collection of venous peripheral blood samples was performed on admission for PC and MPV measurements. Results: The two groups exhibited similar clinical baseline characteristics. A significantly higher MPV/PC ratio was determined in non-dippers compared to that in dippers and normotensives. The higher MPV/PC ratio was observed in non-dippers in comparison with that in dippers and normotensives (0.046 ± 0.007 to 0.032 ± 0.004 fL/[10⁹/L]; 0.046 ± 0.007 to 0.026 ± 0.004 fL/[10⁹/L], p < 0.001, respectively). A receiver operating characteristic (ROC) curve analysis showed that the optimum cut-off value of the MPV/PC ratio for predicting non-dipping patterns in hypertensive patients was 0.036 (area under the curve [AUC]: 0.98, p < 0.001). According to the cut-off value, sensitivity and specificity were found to be 95% and 95%, respectively. Conclusions: The higher MPV/PC ratio was determined in non-dipper hypertensive subjects in comparison with that in dipper hypertensive subjects. An elevation of platelet activity and an increase in thrombus burden are reflected by an increase in the MPV/PC ratio. The MPV/PC ratio may underlie the increase in cardiovascular risk in non-dippers compared to that in dippers.

Platelet distribution width as a novel indicator of disease activity in systemic lupus erythematosus

Background:

Significance of platelet distribution width (PDW) and mean platelet volume (MPV) in assessing disease activity of systemic lupus erythematosus (SLE) remains unclear. This study was aimed to evaluate PDW and MPV as potential disease activity markers in adult SLE patients.

Materials and Methods:

A total of 204 study participants, including 91 SLE patients and 113 age- and gender-matched healthy controls, were selected in this cross-sectional study. They were classified into three groups: control group (n = 113), active SLE group (n = 54), and inactive SLE group (n = 37). Demographic, clinical, and laboratory data were analyzed.

Results:

In patient group, PDW was statistically higher than that in control group (13.54 ± 2.67 vs. 12.65 ± 2.34, P = 0.012), and in active group, PDW was significantly increased compared to inactive group (14.31 ± 2.90 vs. 12.25 ± 1.55, P < 0.001). However, MPV was significantly lower in SLE group than in control group (10.74 ± 0.94 vs. 11.09 ± 1.14, P = 0.016). PDW was positively correlated with SLE disease activity index (P < 0.001, r = 0.529) and erythrocyte sedimentation rate (P = 0.002, r = 0.321) and negatively correlated with C3 (P < 0.001, r = −0.419). However, there was no significant association between MPV and these study variables. A PDW level of 11.85% was determined as a predictive cutoff value of SLE diagnosis (sensitivity 76.9%, specificity 42.5%) and 13.65% as cutoff of active stage (sensitivity 52.6%, specificity 85.3%).

Conclusion:

This study first associates a higher PDW level with an increased SLE activity, suggesting PDW as a novel indicator to monitor the activity of SLE.

Association between mean platelet volume and hypertension incidence

Mean platelet volume (MPV) is increased in various cardiovascular diseases. We sought to determine the prognostic value of MPV for hypertension. We performed a retrospective cohort study. Baseline characteristics were measured in 9168 individuals without hypertension, and the follow-up period was 9 years. Hypertension was confirmed in 2881 participants during the follow-up period. When the participants were grouped according to MPV quartiles, the hazard ratio of future hypertension gradually increased across the MPV quartiles. The hazard ratios of hypertension for the II, III and IV (high) vs. I (low) quartiles of MPV were 1.13 (95% confidence interval (CI) 1.01-1.25, P=0.027), 1.25 (95% CI 1.12-1.39, P<0.001) and 1.40 (95% CI 1.26-1.55, P<0.001), respectively. In multivariate Cox regression analysis, MPV predicted hypertension independently of age, sex, platelet count, waist circumference, drinking, systolic blood pressure and creatinine levels. The present study indicated that elevated MPV is associated with increased incidence of hypertension independent of other risk factors, which suggests that platelet activity may play a role in hypertension incidence.

Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia

INTRODUCTION AND AIM

Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), red cell distribution width (RDW) and plateletcrit (PCT) have all been recognized as systemic inflammatory response (SIR) markers. Our aim was to evaluate changes in NLR, PLR, RDW, MPV and PCT in preeclampsia and their use in predicting the severity of PE.

STUDY DESIGN

This retrospective cohort study included 219 patients. Of them, 27 had mild PE, 82 had severe PE, and 110 were healthy, normotensive pregnant patients.

RESULTS

There were no significant differences in NLR between the groups (p=0.423). Both PLR and PCT were lower in the patients with severe PE than in the control group, and these differences showed a statistical significance (p=0.007 and p<0.001). On the other hand, both RDW and MPV were statistically higher in the patients with severe PE compared to the control group (p=0.011 and p<0.001). ROC analyzes were used to examine the ability of markers to predict those with severe PE from those with mild PE. Areas under the curve for NLR, PLR and RDW were not statistically significant (p=0.636, 0.104 and 0.36, respectively). For MPV and PCT, the values of area under the curve were 0.641 and 0.712, respectively, and the p values for these parameters statistically differed (p=0.028, p=0.001).

CONCLUSION

MPV or PCT may be clinical useful markers in the prediction of severe PE. Further, prospective multicenter studies are warranted to better reveal the association between SIR markers and PE.

An association of platelet indices with blood pressure in Beijing adults: Applying quadratic inference function for a longitudinal study

The quadratic inference function (QIF) method becomes more acceptable for correlated data because of its advantages over generalized estimating equations (GEE). This study aimed to evaluate the relationship between platelet indices and blood pressure using QIF method, which has not been studied extensively in real data settings.A population-based longitudinal study was conducted in Beijing from 2007 to 2012, and the median of follow-up was 6 years. A total of 6515 cases, who were aged between 20 and 65 years at baseline and underwent routine physical examinations every year from 3 Beijing hospitals were enrolled to explore the association between platelet indices and blood pressure by QIF method. The original continuous platelet indices were categorized into 4 levels (Q1-Q4) using the 3 quartiles of P25, P50, and P75 as a critical value. GEE was performed to make a comparison with QIF.After adjusting for age, usage of drugs, and other confounding factors, mean platelet volume was negatively associated with diastolic blood pressure (DBP) (Equation is included in full-text article.)in males and positively linked with systolic blood pressure (SBP) (Equation is included in full-text article.). Platelet distribution width was negatively associated with SBP (Equation is included in full-text article.). Blood platelet count was associated with DBP (Equation is included in full-text article.)in males.Adults in Beijing with prolonged exposure to extreme value of platelet indices have elevated risk for future hypertension and evidence suggesting using some platelet indices for early diagnosis of high blood pressure was provided.