Neutrophil/Lymphocyte Ratio (NLR) in white blood cell (WBC) count is a marker of inflammation because neutrophils are proinflammatory while some lymphocytes are anti-inflammatory. NLR has been shown to predict the prognosis of patients with heart failure or coronary artery disease. However, it is not fully elucidated what kind of factors cause increased NLR. The purpose of this study is to retrospectively explore the factors that are associated with NLR in Japanese cardiovascular outpatients.Design and Method:
Consecutive patients who visited Cardiovascular Division of Hyogo College of Medicine Hospital and received blood test including complete blood count and serum creatinine from February 2011 to October 2012 were included. Exclusion criteria were history of gastrointestinal surgery, malignancy, major bleeding within 1 year, hematologic diseases, inflammatory diseases, and collagen diseases. Demographic and clinical factors that were associated with NLR were cross-sectionary examined SPSS ver. 20, IBM Japan). Institutional ethics committee approved the study.Results:
Ninety-nine patients met the inclusion criteria (age 69.6 ± 11.0 years, male 58.2 %). Patients with hypertension was 75.5%, and blood pressure was 138.2 ± 23.0/78.6 ± 14.8 mmHg. High WBC count, low hemoglobin, high red cell distribution width-coefficient of variation (RDW-CV), low eGFR were associated with high NLR in univariate analysis. Age, gender, hypertension, diabetes mellitus, dyslipidemia, chronic heart failure, ischemic heart disease, stroke, peripheral artery disease, and medications were not associated with NLR. High WBC count (p = 0.003) and low eGFR (p < 0.001) were independently associated with NLR in multivariate analysis. Chronic kidney disease may increase the cardiovascular morbidity and mortality by increasing NLR.Conclusions:
High NLR was strongly associated with impaired renal function in Japanese cardiovascular outpatients including many hypertensive patients. NLR may helpful for cardiovascular risk assessment in hypertension.