BMI-based Evaluation of Haematological Parameters and Acute Phase Reactants of Hypertensives in Port Harcourt, Nigeria

Background: High blood pressure also called hypertension, is the most prevalent cardiovascular risk factor and a significant contributor to global mortality and morbidity. Hypertension is a multifaceted condition, accounting for around 90% of cases falling into the category of essential hypertension where the exact underlying cause remains unknown. Hypertension has been proven to be a consequence of chronic inflammation of the arterial wall. One can infer that there is a potential link between hypertension and acute phase reactants including fibrinogen and c-reactive protein, although there is an ongoing debate regarding whether hypertension is a consequence of changes in acute phase reactants such as elevated CRP and Fibrinogen levels.

Aim: This study was aimed at assessing the haematological parameters of hypertensives based on age and gender in Port Harcourt, Nigeria.

Methods: A case-control study involving 160 hypertensive individuals and 100 age-matched normotensive controls was carried out in Port Harcourt. Aseptic venipuncture technique was employed to collect 10 milliliters (10mls) of venous blood from the participants, which was then distributed into various vacutainer tubes. Three milliliters (3mls) were allocated to EDTA tubes for a full blood count using the Sysmex Kx-21N haematological autoanalyzer and ESR measurement using the Westergren method. Additionally, 4mls were dispensed into sodium citrate tubes for determining fibrinogen levels and 3mls were placed in plain tubes. The latter underwent centrifugation and the resulting separated serum was utilized for assessing CRP and albumin levels. For the analysis of serum CRP and plasma fibrinogen, the Sandwich ELISA method was employed while serum albumin levels were determined using the Bromocresol green (BCG) binding method.

Results: The neutrophil-to-lymphocyte ratio (NLR) (p=0.042) was significantly higher among hypertensives with normal weight and obese when compared to underweight and overweight. The platelet-to-lymphocyte ratio (PLR) (p=0.012) significantly increased from pre-hypertension to grade 3 hypertension. There was a significant decrease in RBC (p=0.004) with an increase in age.

Conclusion: This study has shown significant disparity in the haematological parameters according to hypertensive grades and a gradual significant increase of the platelet-to-lymphocyte ratio from pre-hypertension to grade 3 hypertension.