The Relationship Between White Blood Cell Counts and Pediatric Hypertension: A Prospective Cohort Study

The Relationship Between White Blood Cell Counts and Pediatric Hypertension: A Prospective Cohort Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The Relationship Between White Blood Cell Counts and Pediatric Hypertension: A Prospective Cohort Study Xiaohua Liang, Di Hu, Lanling Chen, Shunqing Luo, Lun Xiao, Xizou An, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7484387/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 27 Jan, 2026 Read the published version in Journal of Human Hypertension → Version 1 posted 6 You are reading this latest preprint version Abstract Background: Childhood hypertension and prehypertension are critical public health issues. While adult hypertension risk factors are well-established, and different from childhood risk factors. Evidence linking white blood cell counts/subtypes to pediatric hypertension remains limited, with most studies focusing on adults or small pediatric samples. Methods: A prospective cohort study included 5,971 children aged 6-12 years in Chongqing, China was performed at baseline in 2014-2015 and 1,282 children received a 5-year follow-up in 2019. Measurements of 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 detected by Complete Blood Count (CBC) tests. Blood pressure (BP), and anthropometrics indexes were also detected. Multilevel linear mixed and logistic regression models adjusted for confounders were applied to illustrate the relevance of cell counts indicators and blood pressure. Results: 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)) vs. normal BP group. Multi-variants analyses adjusted with confounding factors showed MP negatively correlated with SBP, DBP, MAP and LMR positively correlated(P<0.05). MC and MP reduced hypertension risk while LMR increased it, especially in boys. No significant mediation effect of WBC indices between BMI and BP was found. Conclusions: Peripheral MC, MP, and LMR were significantly associated with pediatric hypertension, with MC and MP as protective factors and LMR as a risk factor, suggesting them as potential biomarkers for childhood hypertension. Health sciences/Diseases/Cardiovascular diseases/Hypertension Health sciences/Risk factors Hypertension White blood cell count Blood pressure Monocyte and macrophage Lymphocyte-monocyte ratio Children Figures Figure 1 Figure 2 Full Text Additional Declarations There is NO conflict of interest to disclose. Tables 1 to 5 are available in the Supplementary Files section. Supplementary Files Supplementarytable1.Thedifferenceofhemodynamicindexesforchildrenunderdifferentlevelsofthevariablesforacohortstudy.docx Supplementary table 1. The difference of hemodynamic indexes for children under different levels of the variables for a cohort study Supplementarytable2.TheincreasedriskofthevariablesinmenonelevatedbloodpressurecomparedwithQ1foracohortstudy.docx Supplementary table 2. The increased risk of the variables in men on elevated blood pressure compared with Q1 for a cohort study Table1.Thebaselinecharacteristicsofparticipantsforacohortstudy.docx Table 1 Table2.Thefollowuphematologicalparametersbetweennormalbloodpressureandelevatedbloodpressuregroup.docx Table 2 Table3.Therelationshipofvariablesinterquartilerangeincreaseandbloodpressurelevelsforacohortstudy.docx Table 3 Table4.Theincreasedriskofthevariablesbyquartileincreaseontheincidenceofprehypertensionandhypertensionforacohortstudy.docx Table 4 Table5.Themediatingeffectofthequartilegroupsofbloodindicatorsinbodymassindexonbloodpressureforacohortstudy.docx Table 5 Cite Share Download PDF Status: Published Journal Publication published 27 Jan, 2026 Read the published version in Journal of Human Hypertension → Version 1 posted Editorial decision: revise 02 Oct, 2025 Reviewers invited by journal 20 Sep, 2025 Editor assigned by journal 18 Sep, 2025 Submission checks completed at journal 09 Sep, 2025 First submitted to journal 04 Sep, 2025 Unknown event 01 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7484387","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":518091380,"identity":"8dd66fa4-87e9-4a5a-b3c9-fe1372d445aa","order_by":0,"name":"Xiaohua 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While adult hypertension risk factors are well-established, and different from childhood risk factors. Evidence linking white blood cell counts/subtypes to pediatric hypertension remains limited, with most studies focusing on adults or small pediatric samples.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: A prospective cohort study included 5,971 children aged 6-12 years in Chongqing, China was performed at baseline in 2014-2015 and 1,282 children received a 5-year follow-up in 2019. Measurements of 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 detected by Complete Blood Count (CBC) tests. Blood pressure (BP), and anthropometrics indexes were also detected. Multilevel linear mixed and logistic regression models adjusted for confounders were applied to illustrate the relevance of cell counts indicators and blood pressure.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: 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)) vs. normal BP group. Multi-variants analyses adjusted with confounding factors showed MP negatively correlated with SBP, DBP, MAP and LMR positively correlated(P\u0026lt;0.05). MC and MP reduced hypertension risk while LMR increased it, especially in boys. No significant mediation effect of WBC indices between BMI and BP was found.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusions: Peripheral MC, MP, and LMR were significantly associated with pediatric hypertension, with MC and MP as protective factors and LMR as a risk factor, suggesting them as potential biomarkers for childhood hypertension.\u003c/p\u003e","manuscriptTitle":"The Relationship Between White Blood Cell Counts and Pediatric Hypertension: A Prospective Cohort Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-01 08:10:32","doi":"10.21203/rs.3.rs-7484387/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"revise","date":"2025-10-02T14:57:16+00:00","index":"","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-20T16:57:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-19T02:12:54+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-09T11:05:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Human Hypertension","date":"2025-09-05T00:15:27+00:00","index":"","fulltext":""},{"type":"checksFailed","content":"","date":"2025-09-01T18:45:12+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-human-hypertension","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"jhh","sideBox":"Learn more about [Journal of Human Hypertension](http://www.nature.com/jhh/)","snPcode":"41371","submissionUrl":"https://mts-jhh.nature.com/cgi-bin/main.plex","title":"Journal of Human Hypertension","twitterHandle":"@jhhypertension","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"cb715025-f491-40ce-a77d-43a835845d65","owner":[],"postedDate":"October 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":55059175,"name":"Health sciences/Diseases/Cardiovascular diseases/Hypertension"},{"id":55059176,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-01-29T08:37:33+00:00","versionOfRecord":{"articleIdentity":"rs-7484387","link":"https://doi.org/10.1038/s41371-026-01115-y","journal":{"identity":"journal-of-human-hypertension","isVorOnly":false,"title":"Journal of Human Hypertension"},"publishedOn":"2026-01-27 05:00:00","publishedOnDateReadable":"January 27th, 2026"},"versionCreatedAt":"2025-10-01 08:10:32","video":"","vorDoi":"10.1038/s41371-026-01115-y","vorDoiUrl":"https://doi.org/10.1038/s41371-026-01115-y","workflowStages":[]},"version":"v1","identity":"rs-7484387","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7484387","identity":"rs-7484387","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}