Red Cell Distribution Width and Inappropriateness of Left Ventricular Mass in Patients with Untreated Essential Hypertension

Abstract

BackgroundLeft ventricular hypertrophy (LVH) was suggested to be an important risk factor for hypertensive vascular complications. Previous studies had also shown that red cell distribution width (RDW) was associated with morbidity and mortality of cardiovascular disease. However, few have yet investigated possible association between RDW and LVH. The aim of the present study was to evaluate the relationship between LVH and RDW levels in hypertensive patients.MethodsPhysical examination, laboratory tests and echocardiography were conducted in 330 untreated newly diagnosed hypertensive patients attending the cardiology consultation unit at the Anzhen Hospital of Beijing. The multivariate logistic regression model was used to verify the independent association between RDW and LVH.Results174 patients without LVH and 156 patients with LVH were rolled in the study. The patients with LVH had higher mean SBP, albumin to creatinine ratio, total cholesterol, RDW and fasting glucose compared with non-LVH group. The mean HDL-cholesterol level was significantly lower in patients with LVH than patients without LVH. The multiple logistic regression model suggested that patients with a higher RDW level were more likely to be LVH (OR=2.187, 95%CI: 1.447-3.307, P<0.001). Other predictive factors for LVH were mean SBP, serum creatinine, glucose level. The receiver operating characteristics (ROC) curves indicated area under the curve was 0.688(95%CI: 0.635-0.737, P<0.001) with a cut-off value of 12.9, the RDW predicted LVH status among hypertensive patients with a sensitivity of 72.4% and a specificity of 60.3%.ConclusionsThe higher RDW level was observed in the LVH group compared with the non-LVH group. RDW might be associated with LVH in hypertensive patients. These data highlight the role of RDW as a predictor of organ damage in essential hypertensive patients.

Increased red blood cell distribution width might predict left ventricular hypertrophy in patients with atrial fibrillation

“…[ 13 , 14 ] RDW has recently attracted increased attention as a marker of LVH in various cardiovascular disease states, including untreated essential hypertension, chronic kidney disease, and ischemic failure heart. Chen et al [ 7 ] demonstrated that RDW was higher in untreated newly diagnosed hypertensive patients with LVH than in patients in the non-LVH group. The multiple logistic regression model indicated that patients with a higher RDW level were more likely to have LVH.…”

“…The multiple logistic regression model indicated that patients with a higher RDW level were more likely to have LVH. [ 7 ] A study that included 73 ambulatory patients with chronic kidney disease found that patients with advanced stage chronic kidney disease with left ventricular diastolic dysfunction were characterized by higher RDW levels than patients with advanced stage chronic kidney disease without left ventricular diastolic dysfunction. [ 15 ] AlNajjar et al [ 16 ] showed that the RDW was essential for evaluating the prognosis of patients with chronic heart failure, and its prognostic strength was comparable to that of NT-proBNP levels.…”

“…[ 6 ] Increased RDW level appear to be an independent predictor of left ventricular hypertrophy in patients with untreated essential hypertension. [ 7 ] Inflammatory status is significantly related to ineffective red blood cells, which is partly reflected by an increase in RDW. [ 8 , 9 ] Other mechanisms, including endothelial damage and oxidative stress, have been posited, [ 10 , 11 ] but the exact pathophysiological underpinnings of the aforementioned associations remain controversial.…”

Predictive value of left ventricular myocardial strain by four‐dimensional speckle tracking echocardiography combined with red cell distribution width in heart failure with preserved ejection fraction

“…Elevated RDW level is also known as anisocytosis. Several studies in recent years have shown that RDW can be used as a potent predictor of morbidity and mortality in a variety of settings, particularly in many cardiovascular problems, such as coronary heart disease, pulmonary arterial hypertension, and HF . The role of RDW in HF is unclear, but its value in HF has been demonstrated to be independent of anemia .…”

“…Several studies in recent years have shown that RDW can be used as a potent predictor of morbidity and mortality in a variety of settings, particularly in many cardiovascular problems, such as coronary heart disease, pulmonary arterial hypertension, and HF. [25][26][27][28] The role of RDW in HF is unclear, but its value in HF has been demonstrated to be independent of anemia. 29,30 With regard to the biological interaction between impaired hematopoiesis and cardiac dysfunction, many of the various situations related to increased heterogeneity of erythrocyte volume (ie, aging, inflammation, oxidative stress, nutritional deficiencies, and renal dysfunction) may exist concomitantly in patients with HF, while anisocytosis may also directly result in the progression and deterioration of HF.…”