Background: Arterial stiffness and wave reflections are independent markers and predictors for cardiovascular events in patients with hypertension. White blood cell (WBC) count has been associated with high incidence of cardiovascular events. The aim of the present study was to assess the relationship between WBC count and augmentation index (AIx), a composite measure of arterial stiffness and wave reflections, in patients with essential hypertension.

Methods: We studied 235 consecutive patients with uncomplicated, never treated essential hypertension (mean age 51 years, 63% males). AIx was evaluated with a validated system (Sphygmocor) using applanation tonomentry of the radial artery and pulse wave analysis. AIx was then adjusted for a steady heart rate of 75 beats/min (AIx₇₅). WBC, high sensitivity C-reactive protein (hsCRP) and serum amyloid A (SAA) were measured in all subjects.

Results: In univariate analysis, AIx₇₅ was correlated with both log-hsCRP (r = 0.13, P = 0.04) and log-SAA (r = 0.19, P = 0.002). In stepwise regression analysis, AIx₇₅ was independently associated with log-WBC (β = 12.41, P = 0.02, 95% CI: 1.48–23.34) but not with log-hsCRP (P=NS) and log-SAA (P = 0.07).

Conclusions: WBC count, but not hsCRP, predicts wave reflections in patients with essential hypertension. Considering that WBC count is an inexpensive, readily available laboratory assay, it might be used as a first line inflammatory marker for arterial function and cardiovascular risk assessment.