White blood cell count and incidence of hypertension in the general Japanese population: ISSA-CKD study.

Objectives: This study aimed to clarify the relationship between the white blood cell (WBC) count and hypertension in the general Japanese population.
Methods: We conducted a population-based retrospective cohort study using annual health check-up data of residents of Iki City, Nagasaki Prefecture, Japan. A total of 2935 participants without hypertension at baseline were included in the present analysis. WBC counts were classified as tertile 1 (<4700/μL), tertile 2 (4700-5999/μL), and tertile 3 (≥6000/μL). The outcome was incident hypertension (blood pressure ≥140 mmHg). Multivariable-adjusted hazard ratios and 95% confidence intervals (95% CIs) were estimated using the Cox proportional hazards model.
Result: During an average follow-up of 4.5 years, 908 participants developed hypertension. The incidence (per 100 person-years) of hypertension increased with an elevation in the WBC count (6.3 in tertile 1, 7.0 in tertile 2, and 7.4 in tertile 3). This association was significant, even after adjustment for other risk factors, including age, sex, current smoking habits, current alcohol intake, exercise habits, obesity, elevated blood pressure, diabetes mellitus, and dyslipidemia. The hazard ratios were 1.07 for tertile 2 (95% CI 0.90-1.26) and 1.27 for tertile 3 (95% CI 1.06-1.51) compared with the reference group of tertile 1 (p = 0.009).
Conclusion: The WBC count was associated with future development of hypertension in the general Japanese population.
Competing Interests: The authors have read the journal's policy, and the authors of this study have the following competing interests to declare: HA received funding from Daiichi Sankyo and Takeda, lecture fees from Bayer, Daiichi Sankyo, Fukuda Denshi, MSD, Takeda and Teijin, and fees for consultancy from Kyowa Kirin outside of this work. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare. There are no other conflicts of interest to disclose.