Predictive value of red blood cell distribution width for nocturnal hypertension

doi:10.3877/cma.j.issn.1674-0785.2025.08.004

Abstract

Abstract:

Objective

To evaluate the predictive value of red cell distribution width (RDW) for nocturnal hypertension in patients with hypertension.

Methods

This study enrolled 293 hypertensive patients who were admitted to the Department of Cardiology, The Third Hospital of Changsha between January 2020 and December 2022, and who underwent measurements of homocysteine (Hcy), N-terminal pro-brain natriuretic peptide (NT-proBNP), and 24-hour ambulatory blood pressure monitoring. Based on ambulatory blood pressure results, the patients were divided into a non-nocturnal hypertension group (n=100) and a nocturnal hypertension group (n=193). The association between RDW and nocturnal hypertension was assessed using receiver operating characteristic (ROC) curve analysis and multivariate logistic regression.

Results

The prevalence of nocturnal hypertension was 65.9%. Significant differences were observed between the two groups in terms of RDW, prevalence of type 2 diabetes mellitus, chronic kidney disease, triglyceride levels, and NT-proBNP levels (all P＜0.05). The area under the ROC curve of RDW for predicting nocturnal hypertension was 0.727 (95% confidence interval [CI]: 0.665–0.788). Using the Youden index, the optimal RDW cut-off value was determined to be 13.25%. At this threshold, the sensitivity of RDW for predicting nocturnal hypertension was 69.9%, and the specificity was 77.0%. After adjusting for potential confounders, multivariate logistic regression analysis confirmed that elevated RDW ≥13.25% was independently associated with nocturnal hypertension (odds ratio=3.280, 95%CI: 1.676~6.421, P＜0.001).

Conclusion

RDW is closely associaled with nocturnal hypertension and may be a potential biomarker for predicting this codition.

Key words: Red blood cell distribution width, Nocturnal hypertension, Ambulatory blood pressure monitoring

Yumin Zhang, Yong Duan, Xiaoxia Xiao, Hui Li, Pei Liu. Predictive value of red blood cell distribution width for nocturnal hypertension[J]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(08): 582-588.

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Figures/Tables 3

变量	非夜间高血压（n=100）	夜间高血压（n=193）	t/χ²/U值	P值
RDW[%，M（Q₁，Q₃）]	12.8（12.5，13.2）	13.6（13.05，14.45）	-6.369	＜0.001
年龄（岁， $x ¯$ ±s）	67.86±9.63	66.69±11.42	0.877	0.381
男性[例（%）]	38（38）	107（55.4）	1.161	0.281
吸烟史[例（%）]	20（20）	47（24.4）	0.707	0.400
饮酒史[例（%）]	15（15）	26（13.5）	0.128	0.721
合并症[例（%）]
2型糖尿病	15（15）	49（25.4）	4.164	0.041
高脂血症	42（42）	92（47.7）	0.853	0.356
冠心病	28（28）	42（21.8）	1.410	0.235
脑卒中	8（8）	30（15.5）	3.220	0.073
慢性肾脏病	8（8）	30（15.5）	4.254	0.039
使用药物[例（%）]
CCB [例（%）]	66（66）	142（73.6）	1.835	0.175
ACEI/ARB/ARNI [例（%）]	67（67）	142（73.6）	1.393	0.238
β受体阻滞剂[例（%）]	54（54）	88（45.6）	1.863	0.172
利尿剂[例（%）]	38（38）	65（33.7）	0.540	0.463
α受体阻滞剂[例（%）]	12（12）	31（16.1）	0.868	0.352
TG [mmol/L，M（Q₁，Q₃）]	1.33（0.98，1.94）	1.58（1.06，2.36）	-2.306	0.021
TC（mmol/L， $x ¯$ ±s）	4.57±1.29	4.71±1.15	-0.987	0.324
HDL（mmol/L， $x ¯$ ±s）	1.34±0.37	1.28±0.32	1.375	0.170
LDL（mmol/L， $x ¯$ ±s）	2.53±0.86	2.72±0.91	-1.700	0.090
Cr [µmol/L，M（Q₁，Q₃）]	62.45（53.63，75.73）	64.00（51.53，78.33）	-0.318	0.750
UA [µmol/L，M（Q₁，Q₃）]	309.80（249.00，378.90）	319.00（264.40，401.75）	-1.315	0.189
Hb（g/L， $x ¯$ ±s）	130.62±19.63	132.54±17.50	-0.856	0.393
Hcy [umol/L，M（Q₁，Q₃）]	13.45（10.70，15.83）	14.40（11.10，18.00）	-1.706	0.088
NT-proBNP [pg/ml，M（Q₁，Q₃）]	100（80.75，235.18）	123.90（100.00，237.90）	-2.012	0.048

变量	非夜间高血压（n=100）	夜间高血压（n=193）	t/χ²/U值	P值
RDW[%，M（Q₁，Q₃）]	12.8（12.5，13.2）	13.6（13.05，14.45）	-6.369	＜0.001
年龄（岁， $x ¯$ ±s）	67.86±9.63	66.69±11.42	0.877	0.381
男性[例（%）]	38（38）	107（55.4）	1.161	0.281
吸烟史[例（%）]	20（20）	47（24.4）	0.707	0.400
饮酒史[例（%）]	15（15）	26（13.5）	0.128	0.721
合并症[例（%）]
2型糖尿病	15（15）	49（25.4）	4.164	0.041
高脂血症	42（42）	92（47.7）	0.853	0.356
冠心病	28（28）	42（21.8）	1.410	0.235
脑卒中	8（8）	30（15.5）	3.220	0.073
慢性肾脏病	8（8）	30（15.5）	4.254	0.039
使用药物[例（%）]
CCB [例（%）]	66（66）	142（73.6）	1.835	0.175
ACEI/ARB/ARNI [例（%）]	67（67）	142（73.6）	1.393	0.238
β受体阻滞剂[例（%）]	54（54）	88（45.6）	1.863	0.172
利尿剂[例（%）]	38（38）	65（33.7）	0.540	0.463
α受体阻滞剂[例（%）]	12（12）	31（16.1）	0.868	0.352
TG [mmol/L，M（Q₁，Q₃）]	1.33（0.98，1.94）	1.58（1.06，2.36）	-2.306	0.021
TC（mmol/L， $x ¯$ ±s）	4.57±1.29	4.71±1.15	-0.987	0.324
HDL（mmol/L， $x ¯$ ±s）	1.34±0.37	1.28±0.32	1.375	0.170
LDL（mmol/L， $x ¯$ ±s）	2.53±0.86	2.72±0.91	-1.700	0.090
Cr [µmol/L，M（Q₁，Q₃）]	62.45（53.63，75.73）	64.00（51.53，78.33）	-0.318	0.750
UA [µmol/L，M（Q₁，Q₃）]	309.80（249.00，378.90）	319.00（264.40，401.75）	-1.315	0.189
Hb（g/L， $x ¯$ ±s）	130.62±19.63	132.54±17.50	-0.856	0.393
Hcy [umol/L，M（Q₁，Q₃）]	13.45（10.70，15.83）	14.40（11.10，18.00）	-1.706	0.088
NT-proBNP [pg/ml，M（Q₁，Q₃）]	100（80.75，235.18）	123.90（100.00，237.90）	-2.012	0.048

变量	单因素分析			多因素分析
变量	OR值	95%CI	P值	OR值	95%CI	P值
年龄	0.990	0.968~1.013	0.380
性别
男性	参照
女性	0.763	0.465~1.249	0.282
吸烟	1.301	0.614~2.757	0.492
饮酒	0.873	0.377~2.017	0.750
使用药物
CCB	1.434	0.850~2.420	0.176	1.573	0.898~2.753	0.113
ACEI/ARB/ARNI	1.391	0.811~2.319	0.239
β受体阻滞剂	0.714	0.440~1.159	0.173	0.641	0.379~1.083	0.096
利尿剂	1.029	0.548~1.931	0.929
α受体阻滞剂	1.391	0.554-3.489	0.482
合并症
2型糖尿病	1.928	1.019~3.648	0.044	1.458	0.734~2.893	0.281
高脂血症	1.258	0.773~2.048	0.356
冠心病	0.715	0.411~1.245	0.236
脑卒中	2.094	0.921~4.758	0.078	2.628	1.046~6.602	0.050
慢性肾脏病	1.527	1.011~2.319	0.036	1.357	1.016~2.426	0.008
TG	1.092	0.917~1.301	0.324
TC	1.109	0.903~1.363	0.324
HDL	0.613	0.358~2.016	0.171	0.489	0.225~1.063	0.071
LDL	1.237	0.962~1.685	0.091	1.316	0.969~1.789	0.079
Cr	1.004	0.993~1.014	0.475
UA	1.001	0.999~1.004	0.283
Hb	1.019	0.993~1.019	0.393
Hcy	1.029	0.995~1.064	0.101	1.328	0.938~1.692	0.094
NT-proBNP	1.914	1.025~3.572	0.041	1.518	1.031~2.383	0.067
RDW
RDW正常组	参照
RDW升高组	3.119	1.647~5.909	＜0.001	3.280	1.676~6.421	＜0.001

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