The neutrophil-to-lymphocyte ratio is associated with all-cause and cardiovascular mortality among individuals with hypertension
Authors' conclusion
Elevated NLR independently confers an increased risk for both all-cause and cardiovascular mortality in individuals with hypertension.
Study context
- Population
- Hypertensive adults in National Health and Nutritional Examination Surveys (NHANES) 2009–2014; mortality from the National Death Index
- Participants
- 3,067 adults
- Exposure
- Higher vs lower neutrophil-to-lymphocyte ratio (NLR)
- Outcome
- All-cause and cardiovascular mortality
- Follow-up
- median 92.0-months follow-up
Methodological detailsNHANES 2009–2014, weighted Cox proportional hazards models, mediation analysis
- NHANES 2009–2014
- Weighted Cox proportional hazards models
- Mediation analysis
Main finding
As reported in the abstract
Higher NLR vs Lower NLRHazard ratio (95% CI)P value
All-cause mortality
1.96(1.52–2.52)
P < 0.0001Cardiovascular mortality
2.33(1.54–3.51)
P < 0.0001- Deaths
- 538
- Cardiovascular deaths
- 114
Observational data: associations, not effects.
Further findings
Proportion of the NLR–mortality association mediated by eGFR
- All-cause mortality
- 5.4%
- Cardiovascular mortality
- 4.7%
Time-dependent ROC: AUC of NLR for survival · 3, 5 and 10 years
- All-cause mortality, 3/5/10 years
- 0.68, 0.65 and 0.64
- Cardiovascular mortality, 3/5/10 years
- 0.68, 0.70 and 0.69
Stratified and interaction analyses
- Confirmed the stability of the core results
Original publication
The neutrophil-to-lymphocyte ratio is associated with all-cause and cardiovascular mortality among individuals with hypertension. Cardiovasc Diabetol. Published 2 April 2024. doi:10.
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