Predictive efficacy of NLR for major adverse cardiovascular events in elderly hypertension patients with concomitant obstructive sleep apnea
ZHU Yue
ZHENG Li
ZHANG Honghong
YANG Zeng'ao
WU Zhengfeng
ZHAO Haijing
LIU Yuqi
Abstract：Objective To evaluate the predictive value of neutrophil-to-lymphocyte ratio(NLR)for major adverse cardiovascular events(MACE)in elderly patients with hypertension and obstructive sleep apnea(OSA).Methods A retrospective analysis was conducted on 881 patients with hypertension and OSA treated at First Medical Center of Chinese PLA General Hospital from January 2017 to August 2022.The patients were divided into a young and middle-aged group(621 cases)and an elderly group(260 cases).The young and middle-aged group was further subdivided into MACE1 group(55 cases)and control group 1(566 cases),while the elderly group was divided into MACE2 group(28 cases)and control group 2(232 cases).Clinical data were collected,and all of them were followed up for a median period of 50 months.Results Compared with the young and middle-aged group,the elderly group had significantly higher NLR level[2.08(1.51,2.77)vs 1.83(1.45,2.34),P<0.01].The MACE1 group showed significantly higher apnea hypopnea index(AHI)and NLR levels than the control group 1(P<0.05,P<0.01),and the MACE2 group exhibited same trends than the control group 2(P<0.01).NLR was an independent predictor of MACE in elderly patients with hypertension and OSA(HR=1.46,95%CI:1.18-1.79,P<0.01).ROC curve analysis revealed that the AUC value of NLR in predicting MACE in elderly patients with hypertension and OSA was 0.766,with an optimal cut-off value of 2.34.Kaplan-Meier curve analysis demonstrated that the patients with higher NLR level had poorer prognosis compared with those with lower level(Plog rank<0.01).However,ROC curve analysis indicated that the AUC value of NLR in MACE prediction for the young and middle-aged patients was 0.671,and the optimal cut-off value was 2.04.Conclusion NLR can be used as an independent predictor of MACE in elderly patients with hypertension and OSA,demonstrating good predictive performance.But its predictive value is limited for young and middle-aged patients.
Keywords：hypertensionsleep apneaobstructivemajor adverse cardiovascular events
Publication Date：2026-02-15
Online Publishing Date：2026-03-11(First online date of this platform, not the publication date of the document)
Pages：5( 181-185 )