Evidence mapPaperPMID 41543379Full record

ArticleJournal of clinical hypertension (Greenwich, Conn.)2026

Association Between Neutrophil Percentage-to-Albumin Ratio (NPAR) and Risk of Stroke in Patients With Hypertension: A Cohort Study.

Leyi Wang, Zhihao Liu, Nan Zhang, Long Zhang, Xu Liu, Fangfang Fan, Yan Zhang, Jianping Li

Abstract read
In one paragraph

Article in Journal of clinical hypertension (Greenwich, Conn.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Beyond Statistical Significance: Clinical Relevance of NPAR in Stroke Prediction.Journal of clinical hypertension (Greenwich, Conn.) · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Leyi WangDepartment of Cardiology, Peking University First Hospital, Beijing, China.
Zhihao LiuDepartment of Cardiology, Peking University First Hospital, Beijing, China.
Nan ZhangDepartment of Cardiology, Peking University First Hospital, Beijing, China.
Long ZhangDepartment of Cardiology, Peking University First Hospital, Beijing, China.
Xu LiuDepartment of Cardiology, Peking University First Hospital, Beijing, China.
Fangfang FanDepartment of Cardiology, Peking University First Hospital, Beijing, China.
Yan ZhangDepartment of Cardiology, Peking University First Hospital, Beijing, China.
Jianping LiDepartment of Cardiology, Peking University First Hospital, Beijing, China.

Funding

Capital's Funds for Health Improvement and Research 2024-1-4071Noncommunicable Chronic Diseases-National Science and Technology Major Project 2023ZD0503400/2023ZD0503402Projects of National Natural Science Foundation of China 82370442
6 · The paper itself

Abstract

Stroke is a leading cause of disability among hypertensive adults, with notable sex differences in risk and outcomes. Neutrophil percentage-to-albumin ratio (NPAR) is an easily obtainable composite index of systemic inflammation with prognostic value in cardiovascular disease, but its utility for primary stroke prevention in hypertension remains unclear. We therefore examined the association of NPAR with first stroke in hypertensive adults and tested for sex-specific effects. We analyzed 13 848 participants from the China Stroke Primary Prevention Trial. NPAR was calculated as the neutrophil percentage (%) × 100/albumin (g/dL). Cox proportional hazards models evaluated the association between NPAR and first stroke, and subgroup analyses assessed sex-specific effects. During a median follow-up of 4.5 years, 371 participants (2.7%) experienced stroke. The risk of stroke was significantly higher in Q2, Q3, and Q4 than in Q1 (HR 1.76, 95% CI 1.31-2.36, p < 0.001 [Q2], HR 1.54, 95% CI 1.14-2.08, p = 0.005 [Q3], and HR 1.57, 95% CI 1.17-2.12, p = 0.003 [Q4] in the adjusted model). The result remained consistent when the Q2 to Q4 groups were combined and compared with the Q1 group. Subgroup analysis revealed a significant sex difference, with higher NPAR associated with increased stroke risk in women but not in men (p = 0.035). These findings suggest that higher NPAR independently predicts stroke risk in patients with hypertension, with a substantially stronger association in women, and highlight sex-specific inflammatory mechanisms and the potential of NPAR as a biomarker for female-focused prevention strategies.

Indexed as

HypertensionNeutrophilsSerum AlbuminStrokeAgedChinaCohort StudiesFemaleFollow-Up StudiesHumansInflammationLeukocyte CountMaleMiddle AgedPrognosisProportional Hazards ModelsSerum Albuminhypertensioninflammationneutrophil percentage‐to‐albumin ratiosex difference stroke

Identifiers

PMID41543379
PMCPMC12810400

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.