×
Home Current Archive Editorial board
News Contact
Review paper

Relation of red cell distribution width with dipper and non-dipper hypertension

By
Eyup Buyukkaya ,
Eyup Buyukkaya
Contact Eyup Buyukkaya

Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Turkey

Ali Erayman ,
Ali Erayman

Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Turkey

Esra Karakas ,
Esra Karakas

Department of Endocrinology and Metabolism, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Turkey

Alper Bugra Nacar ,
Alper Bugra Nacar

Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Turkey

Mustafa Kurt ,
Mustafa Kurt

Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Turkey

Sule Buyukkaya ,
Sule Buyukkaya

Department of Cardiology, Antakya State Hospital, Hatay, Turkey

Adnan Burak Akcay ,
Adnan Burak Akcay

Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Turkey

Nihat Sen
Nihat Sen

Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Turkey

Abstract

Aim
Red cell distribution width (RDW), an index of erythrocyte size, is associated with high risk for cardiovascular disease. Nondipping hypertension (HT) is lack of nocturnal fall in blood pressure (BP). The association between RDW and non-dipping BP in normotensive and hypertensive patients was investigated.
Methods
A total of 170 patients were categorized into 4 groups: Normotensive-Dipper (NT-D), Normotensive-Non-dipper (NTND), Hypertensive-Dipper (HT-D) and Hypertensive-Non-dipper (HT-ND). RDW and hs-CRP levels were measured.
Results
Hypertensive patients had higher RDW and hs-CRP levels (14.5 ± 0.87 vs.12.7 ± 0.66, p<0.001 for RDW; 0.99 ± 0.52
vs.0.63 ± 0.43, p<0.001 for hs-CRP). Besides, the RDW levels were higher in non-dippers (13.0 ± 0.63 vs.12.4 ± 0.55, p<0.001 for NT-ND and NT-D; 14.9 ± 0.78 vs.14.2 ± 0.82, p<0.001 for HT-ND and HT-D)
Conclusion
RDW is elevated in non-dipping BP both in normotensive and hypertensive subjects, which may be related with
increased inflammatory state.

References

1.
Greer J, Foerster J, Lukens J, Rodgers G, Paraskevas F, Glader B. Wintrobe’s Clinical Hematology. Lippincott Williams&Wilkins; 2003.
2.
Clarke K, Sagunarthy R, Kansal S. RDW as an additional marker in inflammatory bowel disease/undifferentiated colitis. Dig Dis Sci. 2008. p. 2521–3.
3.
Shehata H, Ali M, Evans-Jones J, Upton G, Manyonda I. Red cell distribution width (RDW) changes in pregnancy. Int J Gynaecol Obstet. 1998. p. 43–6.
4.
Nagajothi N, Braverman A. Elevated red cell distribution width in the diagnosis of thrombotic thrombocytopenic purpura in patients presenting with anemia and thrombocytopenia. South Med J. 2007. p. 257–9.
5.
Fukuta H, Ohte N, Mukai S, Saeki T, Asada K, Wakami K, et al. Elevated plasma levels of B-type natriuretic peptide but not C-reactive protein are associated with higher red cell distribution width in patients with coronary artery disease. Int Heart J. 2009. p. 301–12.
6.
Isik T, Uyarel H, Tanboga I, Kurt M, Ekinci M, Kaya A, et al. Relation of red cell distribution width with the presence, severity, and complexity of coronary artery disease. Coron Artery Dis. 2012. p. 51–6.
7.
Uyarel H, Ergelen M, Cicek G, Kaya M, Ayhan E, Turkkan C, et al. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction. Coron Artery Dis. 201AD. p. 138–44.
8.
Dabbah S, Hammerman H, Markiewicz W, Aronson D. Relation between red cell distribution width and clinical outcomes after acute myocardial infarction. Am J Cardiol. 2010. p. 312–7.
9.
Felker G, Allen L, Pocock S, Shaw L, Mcmurray J, Pfeffer M, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007. p. 40–7.
10.
Messerli F, Williams B, Ritz E. Essential hypertension. Lancet. 2007. p. 591–603.
11.
Kurpesa M, Trzos E, Drozdz J, Bednarkiewicz Z, Krzeminska-Pakula M. Myocardial ischemia and autonomic activity in dippers and non-dippers with coronary artery disease: assessment of normotensive and hypertensive patients. Int J Cardiol. 2002. p. 133–42.
12.
Lurbe E, Redon J, Kesani A, Pascual J, Tacons J, Alvarez V, et al. Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. N Engl J Med. 2002. p. 797–805.
13.
Kario K, Pickering T, Matsuo T, Hoshide S, Schwartz J, Shimada K. Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives. Hypertension. 2001. p. 852–7.
14.
Ozcan F, Turak O, Durak A, Isleyen A, Ucar F, Ginis Z, et al. Red cell distribution width and inflammation in patients with non-dipper hypertension. Blood Press. 2013. p. 80–5.
15.
Gunebakmaz O, Kaya M, Duran M, Akpek M, Elcik D, Eryol N. Red blood cell distribution width in “non-dippers” versus ’dippers. Cardiology. 2012. p. 154–9.
16.
Chobanian A, Bakris G, Black H, Cushman W, Green L, Izzo J, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003. p. 2560–72.
17.
Verdecchia P, Schillaci G, Guerrieri M, Gatteschi C, Benemio G, Boldrini F, et al. Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation. 1990. p. 528–36.
18.
Nutritional anaemias. World Health Organ Tech Rep Ser. 1968. p. 5.
19.
Hogg K, Swedberg K, Mcmurray J. Heart failure with preserved left ventricular systolic function; epidemiology, clinical characteristics, and prognosis. J Am Coll Cardiol. 2004. p. 317–27.
20.
Simel D, Delong E, Feussner J, Weinberg J, Crawford J. Erythrocyte anisocytosis. Visual inspection of blood films vs automated analysis of red blood cell distribution width. Arch Intern Med. 1988. p. 822–4.
21.
Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci. 2009. p. 103–8.
22.
Spell D, Jones D, Harper J, W. David Bessman J. The value of a complete blood count in predicting cancer of the colon. Cancer Detect Prev. 2004. p. 2837–42.
23.
Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation. 2008. p. 163–8.
24.
Lippi G, Targher G, Montagnana M, Salvagno G, Zoppini G, Guidi G. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009. p. 628–32.
25.
Sesso H, Buring J, Rifai N, Blake G, Gaziano J, Ridker P. C-reactive protein and the risk of developing hypertension. JAMA. 2003. p. 2945–51.
26.
Birkenhager A, Van Den Meiracker A. Causes and consequences of a non-dipping blood pressure profile. Neth J Med. 2007. p. 127–31.
27.
Karakas M, Buyukkaya E, Kurt M, Karakas E, Buyukkaya S, Akcay A, et al. Assessment of left ventricular dyssynchrony in dipper and non-dipper hypertension. Blood Press. 2013. p. 144–50.
28.
Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002. p. 2183–9.
29.
Hoshide S, Kario K, Hoshide Y, Umeda Y, Hashimoto T, Kunii O, et al. Associations between nondipping of nocturnal blood pressure decrease and cardiovascular target organ damage in strictly selected community-dwelling normotensives. Am J Hypertens. 2003. p. 434–8.
30.
Verdecchia P, Schillaci G, Boldrini F, Guerrieri M, Porcellati C. Sex, cardiac hypertrophy and diurnal blood pressure variations in essential hypertension. J Hypertens. 1992. p. 683–92.
31.
Tanindi A, Topal F, Topal F, Celik B. Red cell distribution width in patients with prehypertension and hypertension. Blood Press. 2012. p. 177–81.
32.
Minetti M, Malorni W. Redox control of red blood cell biology: the red blood cell as a target and source of prooxidant species. Antioxid Redox Signal. 2006. p. 1165–9.
33.
Berliner S, Rogowski O, Aharonov S, Mardi T, Tolshinsky T, Rozenblat M, et al. Erythrocyte adhesiveness/aggregation: a novel biomarker for the detection of low-grade internal inflammation in individuals with atherothrombotic risk factors and proven vascular disease. Am Heart J. 2005. p. 260–7.

Citation

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.