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Objective <p>This study aims to investigate novel inflammatory markers, including the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and aggregate inflammatory score index (AISI), and their relationship with coronary heart disease (CHD) in patients with hypertension (HT) using data from the National Health and Nutrition Examination Survey (NHANES).</p> Methods <p>We conducted a cross-sectional study using complete data from the 2005–2016 NHANES survey. A total of 9,242 hypertensive participants aged 18 years or older were included in the study. Participants were divided into HT group and HT combined with CHD group. SII was calculated as PC × NC/LC, SIRI was calculated as NC × MC/LC, and AISI was calculated as MC × PC × NC/LC. Additionally, demographic, lifestyle factors and health-related information was gathered. Logistic regression models were utilized to pinpoint SII, SIRI, and AISI associated with HT combined with CHD, and constructed three nomogram models to forecast HT combined with CHD risk.</p> Results <p>In our cohort of 9,242 patients, 2,055 (30.77%) had CHD. Higher levels of log2-SII (OR 1.10, 95%CI: 1.03–1.17, <i>P</i> = 0.003), log2-SIRI (OR 1.27, 95%CI: 1.19–1.35, <i>P</i> &lt; 0.001) and log2-AISI (OR 1.13, 95%CI: 1.07–1.19, <i>P</i> &lt; 0.001) were associated with an increased likelihood of CHD in hypertensive patients. Elevated log<sub>2</sub>-SII, log<sub>2</sub>-SIRI, and log<sub>2</sub>-AISI, along with male gender, older age, non-Mexican American ethnicity, family poverty income ratio (PIR) &lt; 1.5, and smoking, were identified as risk factors for CHD in hypertensive populations. Calibration curves were constructed to assess the deviation between predicted and actual values, with 1,000 bootstrap iterations showing good consistency between predictions and observed outcomes. AUC values of the three models were 0.724 (95% CI: 0.712–0.736), 0.730 (95% CI: 0.718–0.741), and 0.726 (95% CI: 0.714–0.737), respectively. All the three models had good discrimination power. Decision curve analysis indicated that all three nomogram models are effective in clinical practice.</p> Conclusion <p>These novel immune-inflammatory markers (SII, AISI, SIRI) offer a simple, non-invasive, and cost-effective screening tool with promising clinical application for predicting CHD risk in HT population. They have the potential to guide personalized treatment, aligning with the goals of precision medicine.</p>

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Association between novel Immune-Inflammatory markers and hypertension patients with coronary heart disease: A Cross-Sectional study based on NHANES (2005–2016)

  • 期刊论文

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  • 发表日期：

    2025年7月4日

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  • Ruiyuan Li,
  • Aili Atawula,
  • Haonan Li,
  • Moran Li,
  • Jiamin Tang,
  • Jie Liu,
  • Jieying Shi,
  • Jingjing Hou,
  • Feng Hai,
  • Yifan Zhao,
  • Lipeng Guo

摘要

Objective

This study aims to investigate novel inflammatory markers, including the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and aggregate inflammatory score index (AISI), and their relationship with coronary heart disease (CHD) in patients with hypertension (HT) using data from the National Health and Nutrition Examination Survey (NHANES).

Methods

We conducted a cross-sectional study using complete data from the 2005–2016 NHANES survey. A total of 9,242 hypertensive participants aged 18 years or older were included in the study. Participants were divided into HT group and HT combined with CHD group. SII was calculated as PC × NC/LC, SIRI was calculated as NC × MC/LC, and AISI was calculated as MC × PC × NC/LC. Additionally, demographic, lifestyle factors and health-related information was gathered. Logistic regression models were utilized to pinpoint SII, SIRI, and AISI associated with HT combined with CHD, and constructed three nomogram models to forecast HT combined with CHD risk.

Results

In our cohort of 9,242 patients, 2,055 (30.77%) had CHD. Higher levels of log2-SII (OR 1.10, 95%CI: 1.03–1.17, P = 0.003), log2-SIRI (OR 1.27, 95%CI: 1.19–1.35, P < 0.001) and log2-AISI (OR 1.13, 95%CI: 1.07–1.19, P < 0.001) were associated with an increased likelihood of CHD in hypertensive patients. Elevated log2-SII, log2-SIRI, and log2-AISI, along with male gender, older age, non-Mexican American ethnicity, family poverty income ratio (PIR) < 1.5, and smoking, were identified as risk factors for CHD in hypertensive populations. Calibration curves were constructed to assess the deviation between predicted and actual values, with 1,000 bootstrap iterations showing good consistency between predictions and observed outcomes. AUC values of the three models were 0.724 (95% CI: 0.712–0.736), 0.730 (95% CI: 0.718–0.741), and 0.726 (95% CI: 0.714–0.737), respectively. All the three models had good discrimination power. Decision curve analysis indicated that all three nomogram models are effective in clinical practice.

Conclusion

These novel immune-inflammatory markers (SII, AISI, SIRI) offer a simple, non-invasive, and cost-effective screening tool with promising clinical application for predicting CHD risk in HT population. They have the potential to guide personalized treatment, aligning with the goals of precision medicine.