Inverted U-shaped curve relationship between red blood cell distribution width and hypertension in a large health checkup population in China

Jiang, Mingfei; Zha, Xiaojuan; Wu, Zewei; Zhu, Xinying; Li, Wenbo; Wu, Huan; Ma, Jun; Wang, Shuyi; Wen, Yufeng

doi:10.1016/j.jash.2018.03.003

Cited by 6 publications

(6 citation statements)

References 27 publications

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“…Recently, RDW has been found to be a strong independent predictor of all-cause mortality in coronary atherosclerotic heart disease (CAD), acute coronary syndrome (ACS), hypertension, and diabetic nephropathy. 22 , 23 Univariate analysis of this study showed that RDW was associated with SLE-MS, similar to our previous survey of metabolic syndrome in community physical examination populations, suggesting that RDW, a simple, inexpensive and readily available parameter, has good early warning and prognostic evaluation values in SLE-MS. 18 The univariate analysis of this study showed that SLEDAI was associated with MS in SLE, indicating that MS may affect the severity of SLE disease.…”

Section: Discussionsupporting

confidence: 87%

Metabolic syndrome in systemic lupus erythematosus was closely related to body mass index, blood pressure, blood sugar, blood lipids, and arthritis

Jin¹,

Tao²,

Zhou³

et al. 2020

Pak J Med Sci

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Background and Objective: Prevention and control of metabolic syndrome is the key to improving the development of systemic lupus erythematosus. The aim of this study was to analyze the relevant factors regarding metabolic syndrome (MS) in systemic lupus erythematosus (SLE). Methods: A total number of 1238 SLE patients in Yijishan Hospital of Wannan Medical College, Anhui province, from February 2012 to July 2017, were analyzed retrospectively. SLE patients with MS were grouped to group SLE-MS, the others without MS was grouped to group SLE-nMS. The two groups were compared with respect to general characteristics, clinical signs, and laboratory parameters. Random forest approach and multivariate logistic regression were conducted to analyze the related factors regarding MS in SLE. Results: The constituent ratio of metabolic syndrome was 27.14% (336/1238). More SLE patients with MS presented with more farmers, more married people, lower education level, and more lupus nephritis, proteinuria, oral ulcers, tubular urine, hematuria than SLE patients without MS (P<0.05). Moreover, eighteen important variables, whose average importance scores were highest and whose error rates were lowest, were selected by random forest method. Data from multivariate logistic regression showed that MS in SLE was related with BMI, diastolic blood pressure, systolic blood pressure, fasting blood glucose, arthritis, urea, triglycerides, high-density lipoprotein, and white blood cells. Conclusion: MS in SLE was closely related to BMI, blood pressure, blood sugar, blood lipids, arthritis, white blood cells, and urea. Targeted prevention and conclusion measures for the risk factors should be taken as early as possible. doi: https://doi.org/10.12669/pjms.36.6.2093 How to cite this:Jin LR, Tao MJ, Zhou J, Xu L, Li Q, Li Z, et al. Metabolic syndrome in systemic lupus erythematosus was closely related to body mass index, blood pressure, blood sugar, blood lipids, and arthritis. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2093 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 87%

Metabolic syndrome in systemic lupus erythematosus was closely related to body mass index, blood pressure, blood sugar, blood lipids, and arthritis

Jin¹,

Tao²,

Zhou³

et al. 2020

Pak J Med Sci

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“…In another cross-sectional study, including healthy Chinese people who participated to a health checkup, blood pressure (BP) was systemically measured in over 300,000 patients. According to cut off values of ≥140 mmHg or/and over ≥90 mmHg for BP, or medication for controlling BP, the authors found that hypertension, SBP and diastolic BP displayed an inverted U-shaped relationship with RDW values, exhibiting also different peaks between genders (14). In another cross-sectional study an association between RDW and circadian patterns of BP was identified.…”

Section: Factors Affecting the Rdwmentioning

confidence: 95%

The role of red blood cell distribution width (RDW) in cardiovascular risk assessment: useful or hype?

Fava¹,

Cattazzo²,

Hu³

et al. 2019

Ann. Transl. Med.

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Red blood cell distribution width (RDW) reflects erythrocyte size distribution, thus representing a reliable index of anisocytosis, widely used for the differential diagnosis of micro-and normocytic anaemias. Along with the large use in diagnostic hematology, RDW has been associated with presence and complications of a vast array of human pathologies during the last decades, including cardiovascular (CV)diseases. This article is hence aimed to provide an overview of important studies and systematic reviews with meta-analysis, in which RDW has been associated with CV events and mortality, in the attempt of establishing whether enough evidence exists for supporting its routine use in clinical practice. According to available data it seems reasonable to conclude that although the diagnostic specificity is low, and this measure is still plagued by important lack of standardization, RDW can be regarded as an index of enhanced patient fragility and higher vulnerability to adverse outcomes. Abnormal RDW values shall hence persuade physicians to broaden the diagnostic reasoning over anaemias, especially those due to malnutrition or malabsorption, encompassing a comprehensive assessment of traditional and non-traditional CV risk factors.

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“…This nuanced perspective provides a more accurate description of the relationship between RDW and hypertension. In a study primarily focusing on the Chinese population, after adjusting for age, white blood cell count, BMI, and HDL-C, a reversed U-shaped relationship was revealed, with RDW peaks for both females and males at 14.2% [ 14 ]. Interestingly, this inflection point closely resembles the conclusion of our study.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, another study encompassing 52 subjects reported a negative correlation between RDW and decreased systolic blood pressure (SBP) [ 13 ]. Additionally, a large-scale study conducted on a physical examination population in China revealed a reverse U-shaped relationship between RDW and hypertension, as well as systolic and diastolic blood pressure [ 14 ]. However, the research landscape pertaining to the relationship between RDW and the prevalence of hypertension among American adults remains relatively unexplored.…”

Section: Introductionmentioning

confidence: 99%

Association between red cell distribution width and hypertension: Results from NHANES 1999–2018

Chen,

Hou,

Zhong

et al. 2024

PLoS ONE

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The relationship between red cell distribution width (RDW) and hypertension remains a contentious topic, with a lack of large-scale studies focusing on the adults in the United States. This study aimed to investigate the association between RDW and hypertension among US adults from 1999 to 2018. Methods: Data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. RDW values were obtained from the Laboratory Data’s Complete Blood Count with 5-part Differential—Whole Blood module. Hypertension data were obtained through hypertension questionnaires and blood pressure measurements. Multivariable weighted logistic regression analyses were conducted to assess the association between RDW and hypertension, followed by subgroup and smooth curve analyses. Results: Compared to the non-hypertensive group, the hypertensive group exhibited higher RDW values (13.33±1.38 vs. 12.95±1.27, P <0.001). After adjusting for covariates, weighted multivariable logistic regression analysis revealed a positive correlation between RDW and hypertension prevalence (OR: 1.17, 95% CI 1.13, 1.21, P <0.001). When RDW was included as a categorical variable, participants in the fourth quartile had the highest risk of hypertension (OR: 1.86, 95% CI 1.70, 2.03, P <0.001). Subgroup analysis showed that, except for age, BMI and weak/failing kidneys, gender, race, education level, smoking, alcohol use, congestive heart failure, and stroke did not significantly influence this correlation (all P-values for interaction >0.05).Smooth curve fitting analysis revealed a reverse J-shaped relationship between RDW and hypertension prevalence, with an inflection point at 12.93%. Conclusion: We first explored the relationship between RDW and hypertension among US adults and discovered a reverse J-shaped association, providing further insights into the relationship between blood cell counts and hypertension and offering a new foundation for hypertension prevention and control.

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Inverted U-shaped curve relationship between red blood cell distribution width and hypertension in a large health checkup population in China

Cited by 6 publications

References 27 publications

Metabolic syndrome in systemic lupus erythematosus was closely related to body mass index, blood pressure, blood sugar, blood lipids, and arthritis

Metabolic syndrome in systemic lupus erythematosus was closely related to body mass index, blood pressure, blood sugar, blood lipids, and arthritis

The role of red blood cell distribution width (RDW) in cardiovascular risk assessment: useful or hype?

Association between red cell distribution width and hypertension: Results from NHANES 1999–2018

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