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C-reactive protein elevation predicts pulse pressure reduction in hypertensive subjects
Jacques Amar1, Jean-Bernard Ruidavets, Jean-Claude Peyrieux
1Department of Internal Medicine and Hypertension, CHU Purpan, Toulouse Cedex 9, France. amar.j@chu-toulouse.fr
Hypertension (Dallas, Tex. : 1979)
|June 16, 2005
Summary
Perindopril plus indapamide significantly reduced C-reactive protein (CRP) levels in hypertensive patients more effectively than atenolol. This reduction was linked to a greater decrease in pulse pressure (PP).
Area of Science:
- Cardiology
- Hypertension Research
- Inflammation Biomarkers
Background:
- Cross-sectional studies indicate a link between elevated pulse pressure (PP) and increased C-reactive protein (CRP) levels, a marker of inflammation.
- Hypertension management aims to reduce cardiovascular risk, with inflammation playing a key role.
Purpose of the Study:
- To investigate if perindopril plus indapamide therapy is more effective than atenolol in lowering CRP levels in hypertensive patients.
- To determine if any CRP reduction is associated with a preferential decrease in PP.
Main Methods:
- Retrospective subgroup analysis of 269 hypertensive patients from the REASON study.
- Comparison of perindopril/indapamide combination therapy versus atenolol over 12 months.
- Assessment of changes in PP and CRP levels (>3 mg/L) as primary outcomes.
Main Results:
- The perindopril/indapamide group showed a greater decrease in PP and a lower proportion of patients with CRP >3 mg/L (17.9% vs. 28.9%, P=0.03) compared to the atenolol group.
- A significant association was found between a greater decrease in PP and achieving lower CRP levels (< or =3 mg/L) at 12 months in patients with baseline CRP >3 mg/L.
- No significant relationship was observed between CRP reduction and changes in systolic or diastolic blood pressure.
Conclusions:
- Perindopril plus indapamide combination therapy is superior to atenolol in reducing elevated CRP levels in hypertensive individuals.
- The anti-inflammatory effect of perindopril/indapamide in this context is significantly associated with its superior ability to reduce pulse pressure.