Inflammation index SIRI is associated with increased all-cause and cardiovascular mortality among patients with hypertension

Songfeng Zhao; Siyuan Dong; Yongkai Qin; Yutong Wang; Baorui Zhang; Aihua Liu

doi:10.3389/fcvm.2022.1066219

Inflammation index SIRI is associated with increased all-cause and cardiovascular mortality among patients with hypertension

Front Cardiovasc Med. 2023 Jan 11:9:1066219. doi: 10.3389/fcvm.2022.1066219. eCollection 2022.

Authors

Songfeng Zhao¹, Siyuan Dong¹, Yongkai Qin¹, Yutong Wang¹, Baorui Zhang², Aihua Liu^{1

3}

Affiliations

¹ Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, China.
² Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
³ Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Abstract

Background: Inflammation plays an essential role in the pathogenesis of hypertension. A novel inflammatory biomarker systemic inflammatory response index (SIRI) is related with all-cause and cardiovascular (CVD) mortality, while the role of SIRI in hypertension patients is unclear.

Methods: A total of 21,506 participants with hypertension were recruited in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. SIRI was calculated as the neutrophil count ^* monocyte count/lymphocyte count. Hypertension was defined according to the examination of blood pressure, prescription, and self-reported physician diagnosis. Survival status was followed through 31 December 2019. The non-linear relationship was assessed using restricted cubic spline analysis. The association of all-cause mortality with SIRI was evaluated using the Kaplan-Meier curve and the weighted Cox regression analysis. The predictive abilities were assessed with Receiver operating curve.

Results: During 189,063 person-years of follow-up, 5,680 (26.41%) death events were documented, including 1,967 (9.15%) CVD related deaths. A J-shaped association was observed between SIRI and all-cause and CVD mortality. The Kaplan-Meier curve indicated the all-cause and CVD mortality risks were higher in high SIRI quartiles compared with lower SIRI quartiles. After adjusting for all covariates, the SIRI was positively associated with the all-mortality risk with HR = 1.19 (1.15, 1.22), and CVD mortality with HR = 1.19 (1.15, 1.24). The result was robust in subgroup analysis and sensitivity analysis.

Conclusion: Elevated SIRI level is associated with increased all-cause and CVD mortality among patients with hypertension. SIRI is considered as a potential inflammatory biomarker in the clinical practice. Further large-scale cohort studies are required to confirm our findings.

Keywords: National Health and Nutrition Examination Survey (NHANES); hypertension; inflammation; mortality; systemic inflammatory response index (SIRI).

Grants and funding

This work was supported by the Natural Science Foundation of China (81771233 and 82171290), Research and Promotion Program of Appropriate Techniques for Intervention of Chinese High-risk Stroke People (GN-2020R0007), BTH Coordinated Development—Beijing Science and Technology Planning Project (Z181100009618035), Beijing Municipal Administration of Hospitals' Ascent Plan (DFL20190501), and Beijing Natural Science Foundation (19L2013 and 22G10396).