The role of the EASIX score in patients with hypertension: a cross-sectional study

Abstract Background Hypertension (HTN) remains a major global health problem, and inadequate blood pressure (BP) control contributes substantially to cardiovascular risk. The endothelial activation and stress index (EASIX), derived from routine laboratory parameters, has been proposed as a marker of vascular stress. Existing studies in hypertensive populations relied on office BP measurements and included patients with multiple comorbidities. This study evaluated the association between EASIX and 24-h ambulatory BP monitoring (ABPM) in a homogeneous cohort with isolated primary HTN. Methods This retrospective cross-sectional study included 192 adults aged 18–70 years diagnosed with HTN and undergoing 24-h ABPM. Patients were categorized into controlled and uncontrolled BP groups according to 24-h, daytime, and nighttime ABPM thresholds defined by the 2024 European Society of Cardiology guideline. The EASIX score was calculated as [lactate dehydrogenase × creatinine]/platelets and log 2 -transformed for analysis. Group comparisons, correlation analyses, multivariable logistic regression, and ROC analyses were performed. Results The EASIX score was significantly higher in the uncontrolled BP group than in the controlled BP group. Logistic regression identified ascending aortic diameter, serum sodium, serum albumin, and log 2 (EASIX) as independent factors associated with BP control status. EASIX demonstrated good discriminative performance in identifying hypertensive patients with inadequate BP control on 24-h ABPM. Conclusions EASIX demonstrated good discriminative performance for identifying hypertensive patients with inadequate BP control on ABPM. These findings suggest its potential role in risk stratification, warranting validation in prospective studies. Graphical Abstract