Association of Platelet‐to‐White Blood Cell Ratio With All‐Cause and Cardiovascular Mortality in Hypertensive Patients
Yuqin Xiong, Han Qian, Qimei ZongIntroduction
This study investigates the prognostic value of the platelet‐to‐white blood cell ratio (PWR), a composite inflammatory indicator derived from routine complete blood count parameters, for all‐cause and cardiovascular mortality in hypertensive populations.
Methods
A retrospective cohort analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) database spanning 1999–2018. The study included 21,608 hypertensive participants aged ≥ 20 years with complete PWR measurements and mortality follow‐up data. Cox proportional hazards regression models were employed to assess associations between PWR and mortality. Restricted cubic splines identified nonlinear relationships, and time‐dependent receiver operating characteristic (ROC) curves evaluated predictive performance.
Results
An inverse association was observed between PWR and mortality risk in hypertensive patients. Each standard deviation increase in PWR was associated with a 10.0% reduction in all‐cause mortality (HR = 0.900, 95% CI: 0.873–0.927, p < 0.001) and a 12.3% reduction in cardiovascular mortality (HR = 0.877, 95% CI: 0.828–0.930, p < 0.001) in fully adjusted models. A characteristic L‐shaped nonlinear relationship was identified, with inflection points at PWR 45.22 for all‐cause mortality and PWR 50.59 for cardiovascular mortality. Time‐dependent ROC analysis also demonstrated modest discriminatory capacity.
Conclusion
This study suggests that PWR might be a potential biomarker for stratifying risk and predicting mortality in hypertensive patients.