Journal of hypertension · 2025
Retinal capillary rarefaction is associated with the systemic immune-inflammatory index in patients with hypertension.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Carnagarin Revathy, Frost Shaun, Martin Eve, Nolde Janis M, Woodhams Louise, Herat Lakshini Y, Chan Justine, Joyson Anu, Kannenkeril Dennis, Kiuchi Marcio G, Lugo-Gavidia Leslie Marisol, Schlaich Markus P
Аннотация
OBJECTIVE: Rarefaction in capillary density is a hallmark of hypertension-mediated microvascular damage. This study aimed to assess the association between clinically accessible inflammatory markers, including the systemic immune-inflammation index (SII), and retinal capillary density, as well as other indicators of microvascular damage.
METHODS: We conducted a cross-sectional analysis of data from 132 consecutive patients with established primary hypertension at the Royal Perth Hospital's tertiary hypertension clinic. All patients underwent noninvasive optical coherence tomographic angiography (OCT-A) for the assessment of retinal capillary density in the foveal region (CDF) and blood sampling for inflammatory markers. We examined the association of the SII - calculated as the product of the neutrophil-lymphocyte ratio and platelet count - and its individual components with retinal capillary rarefaction and other markers of microvascular damage, such as the urinary albumin-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). The results were adjusted for relevant co-variates, including age, sex, 24-h SBP, BMI, antihypertensive medications, lipid levels, and diabetes status.
RESULTS: Retinal capillary rarefaction was associated with increased white cell count, particularly neutrophils, and the SII. Through predictive margin analysis, an optimal cut-off value of 600 x 10 9 /l for SII was determined for median CDF of 34.1 mm 2 . The analysis showed a reduction in CDF of 1.3 mm 2 for every 250 x 10 9 /l increase in SII. Additionally, higher SII levels (≥ 600 x 10 9 /l) were associated with elevated high-sensitivity C-reactive protein (hs-CRP) levels and markers of microvascular damage, such as increased UACR and reduced eGFR.
CONCLUSION: In patients with primary hypertension, SII and related inflammatory markers were associated with retinal rarefaction and renal indices of microvascular damage. SII may serve as a useful clinical marker of microvascular damage in the retinal and renal vascular bed.
METHODS: We conducted a cross-sectional analysis of data from 132 consecutive patients with established primary hypertension at the Royal Perth Hospital's tertiary hypertension clinic. All patients underwent noninvasive optical coherence tomographic angiography (OCT-A) for the assessment of retinal capillary density in the foveal region (CDF) and blood sampling for inflammatory markers. We examined the association of the SII - calculated as the product of the neutrophil-lymphocyte ratio and platelet count - and its individual components with retinal capillary rarefaction and other markers of microvascular damage, such as the urinary albumin-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). The results were adjusted for relevant co-variates, including age, sex, 24-h SBP, BMI, antihypertensive medications, lipid levels, and diabetes status.
RESULTS: Retinal capillary rarefaction was associated with increased white cell count, particularly neutrophils, and the SII. Through predictive margin analysis, an optimal cut-off value of 600 x 10 9 /l for SII was determined for median CDF of 34.1 mm 2 . The analysis showed a reduction in CDF of 1.3 mm 2 for every 250 x 10 9 /l increase in SII. Additionally, higher SII levels (≥ 600 x 10 9 /l) were associated with elevated high-sensitivity C-reactive protein (hs-CRP) levels and markers of microvascular damage, such as increased UACR and reduced eGFR.
CONCLUSION: In patients with primary hypertension, SII and related inflammatory markers were associated with retinal rarefaction and renal indices of microvascular damage. SII may serve as a useful clinical marker of microvascular damage in the retinal and renal vascular bed.