Vol 54, No 6 (2023)
Review article
Published online: 2023-11-14
Pathogenesis of hematological parameters in hypertension
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DOI: 10.5603/ahp.95826
Acta Haematol Pol 2023;54(6):389-398.
Abstract
Hypertension, which is a significant risk factor for cardiovascular disease, is often assessed in clinical settings using reference ranges for various haematological and immunological parameters. Research has indicated that specific haematological parameters, such as red blood cells, red cell distribution width, mean cellular/corpuscular haemoglobin, mean cellular/corpuscular haemoglobin concentration, haemoglobin, hematocrit, mean cellular/corpuscular volume, platelet count, white blood cells, basophils, lymphocytes, neutrophils, monocytes, eosinophils, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, have a role to play in the development of hypertension. This review article focuses explicitly on the pathophysiological aspects of haematological parameters in the pathogenesis of hypertension.
Keywords: hematological parametershypertensionpathogenesis
References
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018; 71(19): e127–e248.
- Adetifa IMO, Hill PC, Jeffries DJ, et al. Haematological values from a Gambian cohort — possible reference range for a West African population. Int J Lab Hematol. 2009; 31(6): 615–622.
- Lugada ES, Mermin J, Kaharuza F, et al. Population-based hematologic and immunologic reference values for a healthy Ugandan population. Clin Diagn Lab Immunol. 2004; 11(1): 29–34.
- Göbel BO, Schulte-Göbel A, Weisser B, et al. Arterial blood pressure. Correlation with erythrocyte count, hematocrit, and hemoglobin concentration. Am J Hypertens. 1991; 4(1 Pt 1): 14–19.
- Sharp DS, Curb JD, Schatz IJ, et al. Mean red cell volume as a correlate of blood pressure. Circulation. 1996; 93(9): 1677–1684.
- Emamian M, Hasanian SM, Tayefi M, et al. Association of hematocrit with blood pressure and hypertension. J Clin Lab Anal. 2017; 31(6).
- Tsuda K, Nishio I. An association between plasma asymmetric dimethylarginine and membrane fluidity of erythrocytes in hypertensive and normotensive men: an electron paramagnetic resonance investigation. Am J Hypertens. 2005; 18(9 Pt 1): 1243–1248.
- Odashiro K, Saito K, Arita T, et al. Impaired deformability of circulating erythrocytes obtained from nondiabetic hypertensive patients: investigation by a nickel mesh filtration technique. Clin Hypertens. 2015; 21: 17.
- Tsuda K. Association of resistin with impaired membrane fluidity of red blood cells in hypertensive and normotensive men: an electron paramagnetic resonance study. Heart and vessels. Heart Vessels. 2016; 31(10): 1724–1730.
- Cicco G, Carbonara MC, Stingi GD, et al. Red blood cell (RBC) deformability, RBC aggregability and tissue oxygenation in hypertension. Clin Hemorheol Microcirc. 1999; 21(3-4): 169–177.
- Vedernikov YP, Kravtsov GM, Postnov YV, et al. Effect of red blood cells and hemoglobin on spontaneously hypertensive and normotensive rat aortas. Am J Hypertens. 1998; 11(1 Pt 1): 105–112.
- Billett HH. Clinical methods: the history, physical, and laboratory examinations. 3rd ed. In: Walker HK, Hall WD, Hurst JW. ed. Hemoglobin and hematocrit. Butterworths, Boston 1990.
- Cirillo M, Laurenzi M, Trevisan M, et al. Hematocrit, blood pressure, and hypertension. The Gubbio Population Study. Hypertension. 1992; 20(3): 319–326.
- Jeong HR, Shim YS, Lee HS, et al. Hemoglobin and hematocrit levels are positively associated with blood pressure in children and adolescents 10 to 18 years old. Sci Rep. 2021; 11(1): 19052.
- Vázquez BY, Martini J, Tsai AG, et al. The variability of blood pressure due to small changes of hematocrit. Am J Physiol Heart Circ Physiol. 2010; 299(3): H863–H867.
- Tarazi RC, Frohlich ED, Dustan HP, et al. Hypertension and high hematocrit. Another clue to renal arterial disease. Am J Cardiol. 1966; 18(6): 855–858.
- Gang Li, Yanyan Z, Zhongwei Z, et al. Association between mean platelet volume and hypertension incidence. Hypertens Res. 2017; 40(8): 779–784.
- Zhang J, Li J, Chen S, et al. Modification of platelet count on the association between homocysteine and blood pressure: a moderation analysis in chinese hypertensive patients. Int J Hypertens. 2020; 2020: 5983574.
- El Haouari M, Rosado JA. Platelet function in hypertension. Blood Cells Mol Dis. 2009; 42(1): 38–43.
- Mehta J, Mehta P. Platelet function in hypertension and effect of therapy. Am J Cardiol. 1981; 47(2): 331–334.
- Pusuroglu H, Cakmak HA, Erturk M, et al. Assessment of the relation between mean platelet volume, non-dipping blood pressure pattern, and left ventricular mass index in sustained hypertension. Med Sci Monit. 2014; 20: 2020–2026.
- Mundal HH, Hjemdahl P, Gjesdal K. Acute effects of low dose nicotine gum on platelet function in non-smoking hypertensive and normotensive men. Eur J Clin Pharmacol. 1995; 47(5): 411–416.
- Uçar H, Gür M, Gözükara MY, et al. Relationship between mean platelet volume and morning blood pressure surge in newly diagnosed hypertensive patients. Anatol J Cardiol. 2015; 15(2): 107–112.
- Yang K, Tao L, Mahara G, et al. An association of platelet indices with blood pressure in Beijing adults. Medicine. 2016; 95(39): e4964.
- Guven A, Caliskan M, Ciftci O, et al. Increased platelet activation and inflammatory response in patients with masked hypertension. Blood Coagul Fibrinolysis. 2013; 24(2): 170–174.
- Surgit O, Pusuroglu H, Erturk M, et al. Assessment of mean platelet volume in patients with resistant hypertension, controlled hypertension and normotensives. Eurasian J Med. 2015; 47(2): 79–84.
- Chiu PC, Chattopadhyay A, Wu MC, et al. Elucidation of a causal relationship between platelet count and hypertension: a bi-directional mendelian randomization study. Front Cardiovasc Med. 2021; 8: 743075.
- Gkaliagkousi E, Passacquale G, Douma S, et al. Platelet activation in essential hypertension: implications for antiplatelet treatment. Am J Hypertens. 2010; 23(3): 229–236.
- Gomi T, Ikeda T, Shibuya Y, et al. Effects of antihypertensive treatment on platelet function in essential hypertension. Hypertens Res. 2000; 23(6): 567–572.
- Schillaci G, Pirro M, Pucci G, et al. Prognostic value of elevated white blood cell count in hypertension. Am J Hypertens. 2007; 20(4): 364–369.
- Siedlinski M, Jozefczuk E, Xu X, et al. White blood cells and blood pressure: a Mendelian randomization study. Circulation. 2020; 141(16): 1307–1317.
- Ishida S, Kondo S, Funakoshi S, et al. White blood cell count and incidence of hypertension in the general Japanese population: ISSA-CKD study. PLoS One. 2021; 16(2): e0246304.
- Shankar A, Klein BEK, Klein R. Relationship between white blood cell count and incident hypertension. Am J Hypertens. 2004; 17(3): 233–239.
- Karanovic S, Lela IV, Capkun V, et al. White blood cell count is related to blood pressure values only in advanced hypertension: PP. 19.240. J Hypertens. 2010; 28: e320–e321.
- Gillum RF, Mussolino ME. White blood cell count and hypertension incidence. The NHANES I Epidemiologic Follow-up Study. J Clin Epidemiol. 1994; 47(8): 911–919.
- Shi H, Chu H, Lv Z, et al. Association of white blood cell counts with left ventricular mass index in hypertensive patients undergoing anti-hypertensive drug therapy. Exp Ther Med. 2017; 13(4): 1566–1571.
- Guzik TJ, Hoch NE, Brown KA, et al. Role of the T cell in the genesis of angiotensin II induced hypertension and vascular dysfunction. J Exp Med. 2007; 204(10): 2449–2460.
- Zhang J, Crowley SD. Role of T lymphocytes in hypertension. Curr Opin Pharmacol. 2015; 21: 14–19.
- Schiffrin EL. T lymphocytes: a role in hypertension? Curr Opin Nephrol Hypertens. 2010; 19(2): 181–186.
- Mikolajczyk TP, Guzik TJ. Adaptive immunity in hypertension. Curr Hypertens Rep. 2019; 21(9): 68.
- Araos P, Figueroa S, Amador CA. The role of neutrophils in hypertension. Int J Mol Sci. 2020; 21(22).
- Krishnan J, de la Visitación N, Hennen EM, et al. IsoLGs (isolevuglandins) drive neutrophil migration in hypertension and are essential for the formation of neutrophil extracellular traps. Hypertension. 2022; 79(8): 1644–1655.
- Loperena R, Van Beusecum JP, Itani HA, et al. Hypertension and increased endothelial mechanical stretch promote monocyte differentiation and activation: roles of STAT3, interleukin 6 and hydrogen peroxide. Cardiovasc Res. 2018; 114(11): 1547–1563.
- Carmo LS, Xiao L, Loperena R, et al. Abstract P160: hypertension is associated with monocytes activation in the blood in mice and humans. Hypertension. 2018; 72(Suppl_1).
- Ishibashi M, Hiasa Ki, Zhao Q, et al. Critical role of monocyte chemoattractant protein-1 receptor CCR2 on monocytes in hypertension-induced vascular inflammation and remodeling. Circ Res. 2004; 94(9): 1203–1210.
- Hilgers KF. Monocytes/macrophages in hypertension. J Hypertens. 2002; 20(4): 593–596.
- Schweigert O, Adler J, Längst N, et al. CRIP1 expression in monocytes related to hypertension. Clin Sci (Lond). 2021; 135(7): 911–924.
- Zhang J, Yang L, Ding Y. Effects of irbesartan on phenotypic alterations in monocytes and the inflammatory status of hypertensive patients with left ventricular hypertrophy. BMC Cardiovasc Disord. 2021; 21(1): 194.
- Wenzel P, Knorr M, Kossmann S, et al. Lysozyme M-positive monocytes mediate angiotensin II-induced arterial hypertension and vascular dysfunction. Circulation. 2011; 124(12): 1370–1381.
- Olsen F. Correlation between infiltration of mononuclear cells and production of connective tissue in acute hypertensive vascular disease. Acta Pathol Microbiol Scand A. 1971; 79(1): 15–21.
- Wenzel P. Monocytes as immune targets in arterial hypertension. Br J Pharmacol. 2019; 176(12): 1966–1977.
- Herrera J, Ferrebuz A, MacGregor EG, et al. Mycophenolate mofetil treatment improves hypertension in patients with psoriasis and rheumatoid arthritis. J Am Soc Nephrol. 2006; 17(12 Suppl 3): S218–S225.
- Justin Rucker A, Crowley SD. The role of macrophages in hypertension and its complications. Pflugers Arch. 2017; 469(3-4): 419–430.
- Zhao Z, Ni Y, Chen J, et al. Increased migration of monocytes in essential hypertension is associated with increased transient receptor potential channel canonical type 3 channels. PLoS One. 2012; 7(3): e32628.
- Liu X, Zhang Q, Wu H, et al. Blood neutrophil to lymphocyte ratio as a predictor of hypertension. Am J Hypertens. 2015; 28(11): 1339–1346.
- Chen C, Zhao HY, Zhang YH. Correlation between neutrophil-to-lymphocyte ratio and kidney dysfunction in undiagnosed hypertensive population from general health checkup. J Clin Hypertens (Greenwich). 2020; 22(1): 47–56.
- Hou M, Cao L, Ding Y, et al. Neutrophil to lymphocyte ratio is increased and associated with left ventricular diastolic function in newly diagnosed essential hypertension children. Front Pediatr. 2021; 9: 576005.
- Sun X, Luo L, Zhao X, et al. The neutrophil-to-lymphocyte ratio on admission is a good predictor for all-cause mortality in hypertensive patients over 80 years of age. BMC Cardiovasc Disord. 2017; 17(1): 167.
- Jhuang YH, Kao TW, Peng TC, et al. Neutrophil to lymphocyte ratio as predictor for incident hypertension: a 9-year cohort study in Taiwan. Hypertens Res. 2019; 42(8): 1209–1214.
- Yildirim O, Aydin F, Aydin A, et al. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are independent predictors for blood pressure variability. J Hypertens. 2018; 36(Suppl 1): e12.
- Belen E, Sungur A, Sungur MA, et al. Increased neutrophil to lymphocyte ratio in patients with resistant hypertension. J Clin Hypertens (Greenwich). 2015; 17(7): 532–537.
- Mistry HA, Parmar DM. Study of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in hypertensives and normotensives. Int J Clin Exp Physiol. 2019; 5(4): 196–199.
- Bayrakci N, Ozkayar N, Akyel F, et al. The platelet-to-lymphocyte ratio as an inflammation marker in non-dipper hypertensive patients. Hippokratia. 2015; 19(2): 114–118.
- Sunbul M, Gerin F, Durmus E, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens. 2014; 36(4): 217–221.
- Çelebi S. The relationship between platelet to lymphocyte ratio and the diurnal variation of hypertension. Turkish J Clin Laboratory. 2020; 11(2): 29–34.
