Background:

Hypertension is a major global health issue and key cardiovascular risk factor. Beyond classic mechanisms like renin-angiotensin-aldosterone system activation and vascular remodeling, chronic inflammation is increasingly recognized in its pathophysiology. The Systemic Immune-Inflammation Index, calculated from routine blood counts, has gained attention as a potential early indicator of systemic inflammation, especially in primary care.

Research questions:

Can Systemic Immun-Inflammation Index serve as a potential indicator of inflammation in hypertensive individuals in primary care?
Is there a significant difference in Systemic Immun-Inflammation levels between hypertensive patients and healthy individuals?
Does Systemic Immun-Inflammation Index vary by gender or presence of comorbidities in hypertensive patients?

Method:

This retrospective case-control study included 655 hypertensive patients and 669 healthy controls. Systemic immun-inflamationn index was calculated from complete blood count parameters.Normality was assessed using histogram, probability plot and analytical (Kolmogorov-Smirnov/Shapiro-Wilk) tests. Mann-Whitney U test was used for group comparisons.Binary logistic regression identified independent predictors. Model fit was tested with Hosmer-Lemeshow. Receiver Operating Characteristic analysis determined diagnostic value; sensitivity, specificity, positive predictive and negative predictive values were calculated.

Results:

Median Systemic Immun-Inflammation Index levels were significantly higher in the hypertensive group (536.9) than in controls (381.3) (p<0.0001). Newly diagnosed hypertensive patients had even higher index levels than previously diagnosed patients (median: 731.8 vs. 532.5; p<0.0001). No significant difference was found between patients with or without comorbidities. However, index levels were significantly higher in females than males (p=0.003). Systemic immun-inflammation index ≥520.45 predicted hypertension with sensitivity 52.4%, and specificity 83.6%.

Conclusions:

Systemic immun-inflamationn index is significantly elevated in hypertensive patients and may serve as a practical, low-cost inflammatory marker in primary care. Its elevation, particularly in newly diagnosed cases, suggests potential utility in early detection. These findings highlight the importance of integrating inflammation monitoring into hypertension management, possibly paving the way for anti-inflammatory treatment strategies in the future.

Points for discussion:

Could systemic immun-inflamationn index be integrated into routine primary care practice as a low-cost tool for assessing inflammatory burden in hypertensive patients?

How might anti-inflammatory strategies be incorporated into hypertension management if inflammation plays a causal role?

Can systemic immun-inflammation index be used to predict hypertension risk in individuals without a current diagnosis?