Neutrophil Count: A Simple Marker for Cardiovascular Risk?

High peripheral neutrophil counts correlated with excess cardiovascular risk in postmenopausal women with essential hypertension.

Markers of inflammation have been associated with excess cardiovascular risk. In an observational study, Italian investigators assessed peripheral white blood cell and neutrophil counts in relation to risk for cardiovascular (CV) events in 298 initially untreated hypertensive postmenopausal women who had no known CV disease and who had never used hormone therapy (mean age at entry, 59). Participants received tailored antihypertensive treatment from their family physicians.

During a mean follow-up of 8 years, 31 first CV events occurred (17 cardiac and 14 cerebrovascular). Women at very high CV risk by current guidelines of the European Society of Hypertension were ninefold more likely than those at low or moderate risk to experience a CV event (hazard ratio, 9.3; P<0.001). Women with neutrophil counts >4.1x10exp3/µl had more than twice the risk for CV events than did women with counts ≤4.1x10exp3/µl (2.8 per 100 patient-years vs. 1.1 per 100 patient-years). This excess risk remained significant even after adjustment for diabetes and left ventricular hypertrophy at study entry.

Comment: Although neutrophil count added little to participants' CV risk assessment using traditional risk factors, this simple, inexpensive measure might help a clinician when discussing a woman's personal CV risk and the possible need for primary CV prevention with treatments such as statins or aspirin.

— Wendy S. Biggs, MD

Published in Journal Watch Women's Health April 29, 2010