Neutrophil counts and the risk of first stroke in general hypertensive adults
- 9 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Hypertension Research
- Vol. 44 (7), 830-839
- https://doi.org/10.1038/s41440-021-00625-1
Abstract
We aimed to investigate the association between neutrophil counts and first stroke and examine possible effect modifiers among treated hypertensive adults. This is a post hoc analysis of the China Stroke Primary Prevention Trial (CSPPT). A total of 11,878 hypertensive adults with data on neutrophil counts at baseline were included in the current study. The primary outcome was first stroke. During a median follow-up of 4.5 years, 414 (3.5%) participants experienced a first stroke, including 358 with ischemic stroke, 55 with hemorrhagic stroke and one with uncertain type of stroke. Compared with participants in quartile 1 (9/L) of neutrophil counts, those in the upper quartiles (quartile 2–4 [≥2.9 × 109/L]) had a significantly higher risk of first stroke (HR, 1.35; 95% CI: 1.02, 1.78) or first ischemic stroke (HR, 1.38; 95% CI: 1.02, 1.86). Moreover, a strong positive association between neutrophil counts and first ischemic stroke was found in participants with total homocysteine (tHcy) levels P interaction = 0.042) at baseline or time-averaged mean arterial pressure (MAP) ≥102 mmHg (median) (HR, 1.92; 95% CI: 1.27, 2.89; vs. P interaction = 0.015) during the treatment period. However, no such association between neutrophil counts and first hemorrhagic stroke was found. In summary, high baseline neutrophil counts were associated with an increased risk of first ischemic stroke among hypertensive patients, especially in those with low tHcy at baseline or high time-averaged MAP during the treatment period.Keywords
This publication has 36 references indexed in Scilit:
- Efficacy of Folic Acid Therapy in Primary Prevention of Stroke Among Adults With Hypertension in ChinaJAMA, 2015
- Total and Differential White Blood Cell Counts in Late Life Predict 8‐Year Incident Stroke: The Honolulu Heart ProgramJournal of the American Geriatrics Society, 2015
- Neutrophil-Derived Cathelicidin Promotes Adhesion of Classical MonocytesCirculation Research, 2013
- Total white blood cell count or neutrophil count predict ischemic stroke events among adult Taiwanese: report from a community-based cohort studyBMC Neurology, 2013
- Multiple Roles for Neutrophils in AtherosclerosisCirculation Research, 2012
- Total and differential leucocyte counts in relation to incidence of stroke subtypes and mortality: a prospective cohort studyJournal of Internal Medicine, 2012
- Race-specific WBC and neutrophil count reference intervalsInternational Journal of Laboratory Hematology, 2010
- Four Blood Pressure Indexes and the Risk of Stroke and Myocardial Infarction in Japanese Men and WomenCirculation, 2009
- Pulse Pressure and Mean Arterial Pressure in Relation to Ischemic Stroke Among Patients With Uncontrolled Hypertension in Rural Areas of ChinaStroke, 2008
- Leukocyte Count as an Independent Predictor of Recurrent Ischemic EventsStroke, 2004