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The relationship between hematological indices and subclinical atherosclerosis in hypertensive adults in southern Nigeria

Author: 
Unamba Norbert Ndubuisi and Akpa Maclean Romokere
Subject Area: 
Health Sciences
Abstract: 

Background: Atherosclerosis is a primary cause of cardiovascular morbidity and mortality. Atherosclerosis is characterized by infiltration of inflammatory cells from circulating blood. Blood cell activation could play an important role in subclinical atherosclerosis. Carotid intima-media thickness (CIMT) is an established tool for the detection and assessment of subclinical atherosclerosis. We analyzed the relationship between blood cellular markers and quantitative measures of carotid wall atherosclerosis as determined by CIMT in hypertensive patients attending the cardiology clinic of the UPTH. Methods: 144 Hypertensive subjects and 72 age- and sex- matched controls were recruited. Their waist circumference, body mass indices and fasting lipid profile were determined. The complete blood count of the entire study population was also determined. Diabetics were excluded. CIMT was measured in all study subjects using standard protocol. Results were subjected to linear, multiple, and logistic regression analyses. Results: The mean white cell count among the hypertensive subjects was significantly higher than that of the control group (p=0.029). The mean erythrocyte sedimentation rate (ESR) of the hypertensive subjects was also significantly higher than that of the controls (p<0.001). The subjects with elevated CIMT had significantly higher white cell counts than their counterparts with normal CIMT (p=0.005). The individuals with increased CIMT had significantly lower monocyte count than those with normal CIMT (p=0.004). Univariate linear regression showed that total white cell count and monocyte count were associated with increased CIMT. Binary logistic regression showed that the monocyte count was predictive of carotid atherosclerosis. An ROC curve analysis showed that a cutoff value for WCC of 3.55x 109/L yielded a 93% sensitivity and 94% specificity for predicting the presence of carotid atherosclerosis in these hypertensive patients. Conclusion: A significantly positive association between white cell count and atherosclerotic changes in the vascular walls of a hypertensive Nigerian adult population was observed.

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