Mean platelet volume is independently associated with systolic and diastolic blood pressure: a retrospective cross-sectional study.

Abstract

Background: Blood pressure-related cardiovascular risk follows a continuous pattern rather than a dichotomous threshold-based model. In this context, the 2024 European Society of Cardiology (ESC 2024) guidelines emphasize elevated blood pressure as an intermediate-risk category. Low-grade systemic inflammation has been implicated in the pathogenesis of hypertension; however, data regarding inflammatory alterations in individuals with elevated blood pressure remain limited.

Methods: This retrospective cross-sectional study included adults aged 18-65 years attending a general internal medicine outpatient clinic. Participants were classified into three groups based on office blood pressure measurements according to the 2024 ESC guidelines: non-elevated blood pressure, elevated blood pressure, and newly diagnosed hypertension (NDH). Inflammatory and hematological markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), and C-reactive protein (CRP), were compared across groups. Multivariable linear regression analyses were performed to identify independent associations with systolic and diastolic blood pressure.

Results: A total of 284 individuals were included (mean age 46.7 ± 12.0 years; 65.5% male). Nearly half of the cohort was classified as having elevated blood pressure, while 27.5% had NDH. Age, MPV, and CRP differed significantly across blood pressure categories. MPV was significantly higher in the NDH group and remained independently associated with both systolic and diastolic blood pressure after adjustment for age and NLR. NLR showed weak correlations with systolic blood pressure but was not independently associated in multivariable analyses, while PLR and MLR did not differ significantly across blood pressure categories.

Conclusion: Inflammatory and hematological differences were most evident in newly diagnosed hypertension. Mean platelet volume was independently associated with both systolic and diastolic blood pressure. The temporal and mechanistic significance of this association cannot be determined from this cross-sectional study and requires confirmation in longitudinal research. The 2024 ESC blood pressure classification highlights elevated blood pressure as a clinically relevant intermediate-risk state and underscores the potential value of readily available hematological markers in early cardiovascular risk stratification.