Objective To investigate the correlations of the systemic inflammation response index (SIRI) and the aggregate index of systemic inflammation (AISI) with the risk of carotid atherosclerosis in patients with hypertension.

Methods A total of 254 patients with hypertension were retrospectively selected as the study subjects. They were divided into carotid atherosclerosis group (n=158) and non-carotid atherosclerosis group (n=96) based on the presence of carotid atherosclerosis. The carotid atherosclerosis group was further categorized into mild (n=59), moderate (n=52), and severe (n=47) carotid stenosis subgroups according to the degree of carotid stenosis. Clinical data of patients in each group were collected, and the levels of SIRI and AISI were compared. Spearman rank correlation analysis was used to evaluate the correlation between SIRI, AISI, and the presence of carotid atherosclerosis in patients with hypertension. Logistic regression analysis was performed to identify independent risk factors for carotid atherosclerosis in patients with hypertension. Receiver operating characteristic (ROC) curve analysis was employed to assess the predictive value of SIRI and AISI for carotid atherosclerosis in patients with hypertension.

Results The proportion of patients with a history of diabetes, neutrophil count, and monocyte count were higher in the carotid atherosclerosis group than in the non-carotid atherosclerosis group, while the lymphocyte count was lower, with statistically significant differences (P < 0.05). Compared with the non-carotid atherosclerosis group, the levels of SIRI and AISI were elevated in the carotid atherosclerosis group, with statistically significant differences (P < 0.05). Similarly, the mild, moderate, and severe carotid stenosis subgroups showed higher SIRI and AISI levels compared with the non-carotid atherosclerosis group, with statistically significant differences (P < 0.05). Moreover, the levels of SIRI and AISI gradually increased with the severity of carotid stenosis. Spearman rank correlation analysis revealed positive correlations between SIRI, AISI, and both carotid atherosclerosis and the degree of carotid stenosis in patients with hypertension (P < 0.001). Multivariate Logistic regression analysis identified a history of diabetes (OR=3.892, 95%CI, 1.109 to 13.650), high neutrophil levels (OR=3.461, 95%CI, 1.707 to 7.018), high AISI (OR=1.079, 95%CI, 1.052 to1.106), and high SIRI (OR=25.912, 95%CI, 2.903 to 231.260) as independent risk factors for carotid atherosclerosis in patients with hypertension (P < 0.05). The area under the curve (AUC) for combined prediction of SIRI and AISI was higher than that for SIRI alone, with a statistically significant difference (P < 0.05).

Conclusion SIRI and AISI are positively correlated with the risk of carotid atherosclerosis in patients with hypertension. The combined predictive value of SIRI and AISI is superior to that of either index alone.