Background: Hypertension is a leading contributor to global morbidity and mortality. While its vascular complications are well-documented, alterations in hematological parameters among hypertensive individuals remain under-explored. Objective: To compare hematological parameters between hypertensive and normotensive individuals and identify any statistically significant differences. Methods: A retrospective observational study was conducted at Medical college and Hospital, Tertiary care centre, Samayapuram, Tiruchirapalli. Medical records of 420 individuals (215 hypertensive and 205 normotensive) from April 2021 to November 2022 and June 2024 to March 2025 were analyzed. Complete blood count (CBC) reports, including hemoglobin (Hb), total leukocyte count (TLC), platelet count, red cell distribution width (RDW), and mean corpuscular volume (MCV), were extracted and compared between groups using independent t-tests and chi-square tests (significance at p < 0.05). Results: Hemoglobin levels were lower in hypertensives (12.4 ± 1.5 g/dL) compared to controls (13.6 ± 1.3 g/dL, p < 0.001). RDW was significantly elevated in hypertensives (15.1 ± 1.2%) versus normotensives (13.4 ± 1.0%, p < 0.001). Mean platelet count was slightly higher among hypertensives (285.4 ± 70.2 ×10³/μL) than normotensives (270.3 ± 65.8 ×10³/μL, p = 0.032). No significant difference was noted in MCV or TLC. Conclusion: Hypertensive individuals demonstrate significant alterations in hemoglobin and RDW levels, suggesting a potential link between hypertension and subclinical inflammation or erythropoietic dysregulation. These hematological variations warrant further longitudinal evaluation to assess their clinical implications.
Hypertension affects more than 1.28 billion people globally, posing a major public health burden [1]. As a systemic disease, it influences multiple organs and systems, including hematopoietic pathways. While most studies emphasize cardiovascular complications, the hematological milieu in hypertensive individuals is relatively understudied [2].
Chronic inflammation and endothelial dysfunction, hallmarks of hypertension, may influence hematological parameters such as red cell distribution width (RDW), platelet count, and hemoglobin levels [3]. Elevated RDW has been associated with poor cardiovascular outcomes, while variations in hemoglobin and platelet indices may reflect altered hemodynamics and bone marrow response [4].
A few recent studies have reported significant changes in complete blood count (CBC) indices among hypertensive patients [5]. However, data from South Indian populations remain sparse. Considering the diversity of clinical presentations and the potential for early markers of vascular or systemic stress, evaluating routine hematological parameters in hypertensive individuals may yield valuable clinical insights.
The present study aims to evaluate and compare hematological parameters between hypertensive and normotensive individuals, identifying statistically significant trends that may serve as ancillary markers in hypertensive pathophysiology.
This retrospective observational study was conducted at Medical college and Hospital, Tertiary care centre, Samayapuram, Tiruchirapalli. Medical records from two time periods, April 2021 to November 2022 and June 2024 to March 2025, were reviewed.
Sample Size and Selection: A total of 420 patient records were included: 215 with clinically diagnosed essential hypertension and 205 age- and sex-matched normotensive controls attending the outpatient department for general health checkups. Inclusion criteria for hypertensive subjects were blood pressure ≥140/90 mmHg or ongoing antihypertensive therapy. Normotensive controls had systolic BP <120 mmHg and diastolic BP <80 mmHg, with no history of hypertension.
Inclusion Criteria:
Exclusion Criteria:
Data Collection: Data on hemoglobin (Hb), total leukocyte count (TLC), platelet count, RDW, mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC) were extracted from the hospital’s laboratory database.
Statistical Analysis: Data were analyzed using SPSS v25.0. Descriptive statistics were computed. Independent t-tests were used for continuous variables and chi-square tests for categorical variables. A p-value < 0.05 was considered statistically significant.
A total of 420 patients were analyzed: 215 hypertensive (Group A) and 205 normotensive (Group B). Table 1 presents baseline characteristics.
Table 1. Demographic and Basic Hematological Characteristics
|
Parameter |
Group A (Hypertensive) |
Group B (Normotensive) |
p-value |
|
Age (years) |
54.2 ± 10.8 |
52.9 ± 11.1 |
0.298 |
|
Male (%) |
58.6% |
56.1% |
0.631 |
|
Hemoglobin (g/dL) |
12.4 ± 1.5 |
13.6 ± 1.3 |
<0.001 |
|
RDW (%) |
15.1 ± 1.2 |
13.4 ± 1.0 |
<0.001 |
|
Platelet count (×10³/μL) |
285.4 ± 70.2 |
270.3 ± 65.8 |
0.032 |
|
MCV (fL) |
88.3 ± 5.9 |
87.9 ± 6.1 |
0.462 |
|
TLC (×10³/μL) |
7.2 ± 1.9 |
7.0 ± 1.8 |
0.329 |
Hypertensive individuals had significantly lower hemoglobin and higher RDW values. Platelet counts were marginally elevated in hypertensives. No statistically significant differences were noted in MCV or TLC.
This study demonstrated significant differences in hematological parameters between hypertensive and normotensive individuals, notably in hemoglobin, RDW, and platelet counts. Our findings align with several recent studies emphasizing hematological aberrations in hypertensive cohorts.
Lower hemoglobin levels among hypertensives may suggest subclinical hemolysis, reduced erythropoietin response, or chronic low-grade inflammation [6]. A study by Gupta et al. found similar trends, attributing anemia in hypertensive patients to vascular endothelial dysfunction and altered renal perfusion [7].
Elevated RDW in hypertensive individuals has gained attention as a potential marker of cardiovascular risk. RDW reflects the variability in red blood cell size and is influenced by inflammation, oxidative stress, and nutritional status [8]. Lippi et al. reported RDW as an independent predictor of hypertension-related complications, including stroke and left ventricular hypertrophy [9].
The modest but significant increase in platelet count observed in hypertensives may indicate heightened platelet reactivity or aggregation, contributing to prothrombotic states. This is supported by work from Doganay et al., who documented elevated mean platelet volume (MPV) and count in newly diagnosed hypertensive patients [10].
Interestingly, MCV and TLC did not differ significantly between groups, indicating that macrocytosis or systemic leukocytosis is not a hallmark feature in this context [11-15].
The retrospective design and single-center nature are study limitations. Confounding factors such as medication use and nutritional status could not be completely controlled. However, the robust sample size and strict inclusion criteria enhance the internal validity of findings.
Future prospective studies incorporating inflammatory markers like CRP, IL-6, and ferritin may provide further mechanistic insights into the observed hematological changes in hypertension.
This study highlights significant differences in hemoglobin, RDW, and platelet counts between hypertensive and normotensive individuals, suggesting a possible interplay between hypertension and hematological parameters. These findings underscore the importance of routine hematological evaluation in hypertensive patients for early identification of associated risks and complications.
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