The Importance of the De Ritis Ratio and Glasgow Prognostic Score in prehypertensive patients

Year 2021, , 257 - 262, 31.12.2021

Ozge Ozcan Abacıoglu , Arafat Yıldırım , Mustafa Doğduş , Ferhat Dindaş , Fethi Yavuz

https://doi.org/10.30565/medalanya.927573

Abstract

Aim: To evaluate Glasgow prognostic score (GPS) and De Ritis ratio in optimal blood pressure and prehypertensive patients, and investigate whether these parameters can predict antihypertensive treatment in the follow-up period.

Methods: A total of 402 patients who were followed up with a 24-hour ambulatory blood pressure with a pre-diagnosis of hypertension between January 2018 and December 2018 were included in the study. Routine laboratory parameters of the patients were recorded in the hospital digital system. The common health system data of the patients was analyzed until June 2020, and those who were started on antihypertensive treatment were recorded.

Results: 402 patients (mean age 40.16 ± 13.01 years, 49% male) were included in the study. 226 of these were in prehypertension group. The mean GPS and the De Ritis ratio, aspartate transferase levels, mean systolic and diastolic blood pressures were different between the groups (p=0.035, p=0.023, p=0.039, p<0.001 and p=0.012, respectively). When patients whose antihypertensive treatment was started and those who did not receive antihypertensive treatment were compared, age, De Ritis ratio and mean diastolic blood pressure differed between the two subgroups (p<0.001, p=0.015 and p=0.040, respectively). Multivariate logistic regression analysis showed that De Ritis ratio and age were, independently, predictors for antihypertensive treatment (OR:3.064, p=0.015 and OR:1.050, p= 0.001 respectively). In ROC curve analysis, both age and De Ritis ratio were successful at predicting the initiation of antihypertensive treatment with an AUC:0.697 and p<0.001 and AUC:0.630 and p=0.018 respectively.

Conclusion: Both GPS and the De Ritis ratio were found to be significantly higher in prehypertensive patients than those with optimal blood pressure. Moreover, the De Ritis ratio, an easily calculated laboratory parameter, can be used as a predictive value for antihypertensive treatment.

Keywords

De Ritis, Glasgow prognostic score, prehypertension

Prehipertansif Hastalarda De Ritis Oranı ve Glasgow Prognostik Skorunun Önemi

Abstract

Amaç: Optimal kan basıncı ve prehipertansif hastalarda glasgow prognostik skoru (GPS) ve De ritis (AST/ALT) oranını değerlendirmek ve bu parametrelerin takip döneminde antihipertansif tedaviyi tahmin edip edemeyeceğini araştırmayı amaçladık.

Yöntemler: Ocak 2018-Aralık 2018 tarihleri arasında kliniğimizde hipertansiyon ön tanısıyla 24 saat ambulatuvar kan basıncı monitörizasyonu ile izlenen toplam 402 hasta çalışmaya dahil edildi. Hastaların rutin laboratuvar parametreleri hastane dijital sisteminden kaydedildi. Hastaların medikasyon verileri ulusal sağlık sisteminden Haziran 2020'ye kadar analiz edilerek antihipertansif tedavi başlanan hastalar kayıt altına alındı.

Bulgular: Çalışmaya 402 hasta (ortalama yaş 40.16 ± 13.01 yıl) dahil edildi (% 49 erkek). Bunların 226'sı prehipertansiyon grubundaydı. Prehipertansiyon grubunda ortalama GPS ve De Ritis oranı, aspartat transferaz seviyeleri, ortalama sistolik ve diyastolik kan basınçları daha yüksek ve istatistiksel olarak anlamlı belirlendi (sırasıyla p = 0,035, p = 0,023, p = 0,039, p = <0,001 ve p = 0,012). Antihipertansif tedavi başlanan ile başlanmayan hastalar karşılaştırıldığında; yaş, De Ritis oranı ve ortalama diyastolik kan basıncı antihipertansif tedavi alan grupta daha yüksek belirlendi (sırasıyla p <0,001, p = 0,015 ve p = 0,040). Çok değişkenli lojistik regresyon analizinde De Ritis oranı ve yaş antihipertansif tedavi başlanması için bağımsız öngördücüler oldukları saptandı (sırasıyla OR: 3.064, p = 0.015 ve OR: 1.050, p = 0.001). ROC eğrisi analizinde, hem yaş hem de De Ritis oranı sırasıyla EAA: 0.697 ve p <0.001 ve EAA: 0.630 ve p = 0.018 ile antihipertansif tedavinin başlamasını öngörmede başarılıydı.

Sonuç: Hem GPS hem de De Ritis oranı prehipertansif hastalarda optimal kan basıncına sahip olanlara göre anlamlı olarak daha yüksek bulundu. Ayrıca kolay hesaplanan bir laboratuvar parametresi olan De Ritis oranı, antihipertansif tedavi başlanması için bir tahmin değeri olarak kullanılabilir.

Keywords

De Ritis, Glasgow prognostik skoru, prehipertansiyon

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