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Association between pulse pressure and C-reactive protein among apparently healthy US adults
Jerome L Abramson1, William S Weintraub, Viola Vaccarino
1Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30306, USA. jabram3@emory.edu
Insights
Elevated pulse pressure may indicate increased cardiovascular disease risk due to inflammation. This study found higher pulse pressure is linked to elevated C-reactive protein, a key inflammation marker, in healthy US adults.
Area of Science:
- Cardiology
- Inflammation Research
- Public Health
Background:
- Cardiovascular disease (CVD) risk is linked to inflammation.
- Elevated pulse pressure is a known CVD risk factor.
- The relationship between pulse pressure and inflammation markers like C-reactive protein (CRP) is not well understood.
Purpose of the Study:
- To investigate the association between pulse pressure and CRP levels in a large cohort of healthy US adults.
- To determine if pulse pressure is independently associated with elevated CRP, an indicator of inflammation.
Main Methods:
- Cross-sectional analysis of 9867 healthy adults from the Third National Health and Nutrition Examination Survey (NHANES).
- Logistic regression was used to assess the relationship between pulse pressure and elevated CRP (> or = 0.66 mg/dL).
- Models were adjusted for various cardiovascular risk factors, including blood pressure, obesity, smoking, and medication use.
Main Results:
- A 10 mm Hg increase in pulse pressure was associated with a 15% increase in the odds of having elevated CRP.
- This association remained significant after adjusting for systolic blood pressure and other confounders.
- Pulse pressure, but not systolic or diastolic blood pressure alone, was independently associated with elevated CRP levels.
Conclusions:
- Increased pulse pressure is associated with elevated C-reactive protein levels in apparently healthy US adults.
- This finding suggests a potential inflammatory mechanism linking pulse pressure to cardiovascular risk.
- Further research is warranted to explore the clinical implications of this association.
Abstract:
Elevated pulse pressure has been associated with an increased risk of cardiovascular disease, which is increasingly being seen as an inflammatory disease. Thus, the mechanism underlying the link between elevated pulse pressure and cardiovascular disease risk may be inflammation. However, investigators have not examined the relationship between pulse pressure and C-reactive protein, an inflammation marker that has been closely linked to cardiovascular risk. We examined the cross-sectional relationship between pulse pressure and C-reactive protein among 9867 healthy persons 17 years of age or older who participated in the Third National Health and Nutrition Examination Survey. The association between pulse pressure and the odds of having an elevated C-reactive protein level (> or = 0.66 mg/dL) was assessed by logistic regression. In a model that adjusted for systolic blood pressure, demographic factors, cholesterol, measures of obesity, smoking, alcohol consumption, physical activity, and antihypertensive medication use, a 10 mm Hg increase in pulse pressure was associated with a 15% increase in the odds of having an elevated C-reactive protein level (odds ratio, 1.15; 95% confidence interval, 1.01 to 1.31; P=0.04). When the same model was re-run adjusting for diastolic blood pressure instead of systolic blood pressure, a 10 mm Hg rise in pulse pressure was associated with a significant 12% increase in the odds of having an elevated C-reactive protein level. Systolic and diastolic blood pressure were unrelated to C-reactive protein once pulse pressure had been accounted for. Our results suggest that increases in pulse pressure are associated with elevated C-reactive protein levels among apparently healthy US adults, independent of systolic and diastolic blood pressure.