The relationship between white blood cell counts and pediatric hypertension: a prospective cohort study.

This study investigated the relationship between white blood cell counts and pediatric hypertension, addressing the limited evidence on white blood cell counts/subtypes and pediatric hypertension. A prospective cohort study was conducted involving 5971 children aged 6-12 years in Chongqing, China, with baseline data collected in 2014-2015 and 1282 children completed a 5-year follow-up in 2019. White blood cell indicators, including total white blood cell counts (WBC), lymphocyte counts and percentage (LC, LP), monocyte counts and percentage (MC, MP), neutrophil counts and percentage (ANC, NR), and lymphocyte-monocyte ratio (LMR) were measured using Complete Blood Count (CBC) tests. Blood pressure (BP), and anthropometric indices were also measured. Multilevel linear mixed models and logistic regression models, adjusted for confounders were applied to illustrate the relevance of cell counts indicators and blood pressure. Results showed that compared to normal BP (NBP) group, the elevated BP (EBP) group had significant lower MC(OR(95%CIs) = 0.79(0.68,0.90)) and MP(OR(95%CIs) = 0.78(0.68,0.88)) but higher LMR(OR(95%CIs) = 1.31(1.15,1.50)). Multivariate analyses adjusted for confounding factors revealed that MP was negatively correlated with SBP, DBP and MAP, while LMR positively correlated with these blood pressure(P < 0.05). MC and MP were associated with a reduced risk of hypertension, whereas LMR was associated with an increased risk, particularly in boys. No significant mediation effect of WBC indices between BMI and BP was observed. In conclusion, Peripheral MC, MP, and LMR were significantly associated with pediatric hypertension; MC and MP act as protective factors and LMR acts as a risk factor, suggesting that these indices may serve as potential biomarkers for childhood hypertension.