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Increased C-reactive protein concentrations in never-treated hypertension: the role of systolic and pulse pressures
Giuseppe Schillaci1, Matteo Pirro, Fabio Gemelli
1Medicina Interna, Angiologia e Malattie da Arteriosclerosi, Policlinico Monteluce, Università degli Studi di Perugia, Via B. Brunamonti 51, 06122 Perugia, Italy. skill@unipg.it
Insights
Newly diagnosed hypertension is linked to higher C-reactive protein (CRP) levels, a marker of inflammation. Both systolic blood pressure and pulse pressure predict CRP levels, independent of other cardiovascular risks.
Area of Science:
- Cardiovascular Medicine
- Inflammation Biomarkers
- Hypertension Research
Background:
- Systemic inflammation, indicated by C-reactive protein (CRP), is increasingly recognized in cardiovascular disease.
- The relationship between inflammation and newly diagnosed, untreated hypertension requires further elucidation.
Purpose of the Study:
- To investigate elevated plasma C-reactive protein (CRP) concentrations in patients with newly diagnosed, never-treated hypertension.
- To determine if blood pressure and pulse pressure correlate with plasma CRP independently of cardiovascular risk factors.
Main Methods:
- A cross-sectional study was conducted involving 135 newly diagnosed hypertensive patients and 40 healthy controls.
- Office and 24-hour blood pressure measurements, along with plasma CRP and serum lipid levels, were assessed.
Main Results:
- Hypertensive patients exhibited significantly higher plasma CRP levels compared to controls (1.85 mg/l vs. 1.01 mg/l).
- Plasma CRP showed a direct association with systolic blood pressure and pulse pressure, but not diastolic blood pressure, in the overall population and hypertensive patients.
- Multivariate analysis confirmed systolic blood pressure and pulse pressure as significant predictors of plasma CRP, even after controlling for cardiovascular risk factors.
Conclusions:
- Systolic blood pressure and pulse pressure are independent predictors of plasma CRP concentrations in newly diagnosed hypertensive patients.
- These findings suggest a direct link between blood pressure parameters and inflammation, irrespective of traditional cardiovascular risk factors.
Objective:
To test whether the plasma concentration of C-reactive protein (CRP), a sensitive marker of systemic inflammation, is increased in patients with newly diagnosed, never-treated hypertension and whether blood pressure and its pulsatile component, pulse pressure, are correlated with plasma CRP concentration independently of a consistent number of cardiovascular risk factors.
Design:
Cross-sectional study in a hospital outpatient hypertension clinic.
Methods:
A total of 135 newly diagnosed, never-treated patients with hypertension and 40 healthy matched non-hypertensive controls underwent office and 24-h blood pressure measurement and blood sampling for determination of plasma CRP and serum lipid concentrations.
Results:
Plasma CRP concentration was greater in hypertensive individuals (1.85 mg/l, interquartile range 0.74-3.64) than in control individuals (1.01 mg/l, interquartile range 0.67-1.88; P = 0.02). In the entire population, CRP had a significant direct association with office systolic blood pressure and pulse pressure, but not with diastolic blood pressure. Among hypertensive patients, plasma CRP was related to 24-h systolic blood pressure (r = 0.28, P < 0.01) and pulse pressure (r = 0.32, P < 0.01), but not to diastolic blood pressure (r = 0.12, P > 0.2). CRP was also directly associated with body mass index (r = 0.25, P < 0.01), serum low-density lipoprotein cholesterol (r = 0.21, P = 0.03) and serum triglycerides (r = 0.21, P = 0.03). In the multivariate analysis, systolic blood pressure and pulse pressure, but not diastolic blood pressure, were significant predictors of plasma CRP concentration when a consistent number of cardiovascular risk factors was controlled for simultaneously.
Conclusions:
Systolic blood pressure and pulse pressure, but not diastolic blood pressure, are predictors of plasma C-reactive protein concentrations in patients with newly diagnosed, never-treated hypertension, irrespective of the potential proinflammatory action of traditional cardiovascular risk factors.
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