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Is C-reactive protein an independent risk factor for essential hypertension?
L E Bautista1, P López-Jaramillo, L M Vera
1Universidad Industrial de Santander, Fundación Cardiovascular del Oriente Colombiano, South America. lbautista@b-manga.multi.net.co
Insights
High C-reactive protein (CRP) levels may independently predict hypertension risk. This study suggests CRP could be a novel risk factor for developing high blood pressure, warranting further investigation.
Area of Science:
- Cardiovascular epidemiology
- Inflammation and cardiovascular disease
- Hypertension research
Background:
- C-reactive protein (CRP) is a known predictor of coronary heart disease.
- CRP is associated with endothelial dysfunction, a risk factor for hypertension.
- The direct relationship between CRP and hypertension prevalence was previously unstudied.
Purpose of the Study:
- To determine if circulating C-reactive protein (CRP) levels are independently associated with essential hypertension.
- To investigate the role of inflammation, as indicated by CRP, in the development of hypertension.
Main Methods:
- Cross-sectional population-based survey conducted in Bucaramanga, Colombia.
- A random sample of 300 adults aged 30 years and older.
- Circulating CRP levels, arterial blood pressure, and cardiovascular risk factors were measured; binomial regression analyzed CRP's effect on hypertension prevalence.
Main Results:
- Hypertension prevalence was 46.0% in the study population.
- Individuals in higher CRP quartiles exhibited a higher unadjusted prevalence of hypertension.
- After adjusting for multiple risk factors, higher CRP levels remained significantly associated with an increased prevalence of hypertension (P=0.005 for the highest quartile).
Conclusions:
- Circulating C-reactive protein (CRP) levels may represent an independent risk factor for hypertension development.
- The cross-sectional nature necessitates confirmation through prospective cohort studies.
- Further research is needed to elucidate CRP's role in hypertension prediction, diagnosis, and management.
Context:
C-reactive protein (CRP), predicts coronary heart disease incidence in healthy subjects and has been associated with decreased endothelium-dependent relaxation, a potential risk factor for hypertension. However, the relationship between CRP and hypertension has not been studied.
Objective:
To assess whether circulating levels of CRP are independently related to essential hypertension.
Design:
Cross-sectional population survey. We measured circulating levels of CRP, blood pressure and cardiovascular risk factors among participants. Binomial regression was used to calculate the adjusted effect of CRP on the prevalence of hypertension.
Setting:
General community of Bucaramanga, Colombia.
Participants:
A random sample of 300 subjects > or = 30 years old.
Main Outcome Measure:
Arterial blood pressure.
Results:
Overall hypertension prevalence was 46.0%. The unadjusted prevalence of hypertension was 58.7% in the highest quartile of CRP, but only 34.7% in the lowest quartile. After adjustment for age, sex, body mass index, family history of hypertension, fasting glycemia, sedentary behaviour, and alcohol consumption, the prevalence of hypertension was 1.14 [95% confidence interval (CI), 0.82, 1.58; P= 0.442], 1.36 (95% CI, 0.99, 1.87; P= 0.057) and 1.56 (95% CI, 1.14, 2.13; P = 0.005) times higher in subjects in the second, third and fourth quartiles of CRP, as compared to subjects in the first quartile.
Conclusions:
Our results suggest, for the first time, that CRP level may be an independent risk factor for the development of hypertension. However, because of the cross-sectional nature of our study, this finding should be confirmed in prospective cohort studies, aimed at elucidating the role of CRP in the prediction, diagnosis and management of hypertension.