Elevated C-reactive protein augments increased arterial stiffness in subjects with the metabolic syndrome

We examined whether the presence of an increasing number of metabolic syndrome "disorders" was associated with an increasing pulse wave velocity, which is recognized as a marker of cardiovascular risk, and evaluated whether an elevated plasma C-reactive protein level augments this increasing pulse wave velocity. Using a cross-sectional study design, C-reactive protein, metabolic syndrome-related anthropometric parameters, and pulse wave velocity were measured in 5752 middle-aged Japanese men (44+/-10 years old). In linear regression analyses, all of the metabolic "disorders" and the logarithm of the C-reactive protein significantly correlated with pulse wave velocity. Multiple linear regression analysis demonstrated that triglycerides, HDL cholesterol, mean blood pressure, fasting glucose, and the logarithm of the C-reactive protein were significant independent positive predictors of pulse wave velocity (R-square=0.38). The presence of an increasing number of metabolic "disorders" in the subjects was associated with an increasing pulse wave velocity (no disorders 1228+/-139 cm/s > or =3 disorders 1437+/-250 cm/s; P<0.01). Among subjects with the metabolic syndrome, pulse wave velocity was higher in cases with (1508+/-278 cm/s) than in those without an elevated C-reactive protein (1427+/-243 cm/s; P<0.01). In conclusion, an increase in arterial stiffness may constitute a pathophysiological basis for the increased risk of cardiovascular disease in patients with the metabolic syndrome and that an elevated C-reactive protein level may aggravate this cardiovascular risk.