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C-reactive protein, left ventricular mass index, and risk of cardiovascular disease in essential hypertension

Yoshio Iwashima1, Takeshi Horio, Kei Kamide

  • 1Department of Geriatric Medicine, Osaka University Graduate School of Medicine, Suita, Japan.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|March 18, 2008
PubMed

Insights

C-reactive protein (CRP) is linked to increased left ventricular mass index (LVMI) in hypertensive individuals. Elevated CRP levels, especially with left ventricular hypertrophy (LVH), predict a higher risk of cardiovascular disease (CVD) events.

Area of Science:

  • Cardiology
  • Biomarkers
  • Hypertension Research

Background:

  • Essential hypertension is a major risk factor for cardiovascular disease (CVD).
  • Left ventricular hypertrophy (LVH) is a common complication of hypertension and a predictor of CVD.
  • C-reactive protein (CRP) is an inflammatory marker associated with cardiovascular risk.

Purpose of the Study:

  • To examine the association between C-reactive protein (CRP) and left ventricular mass index (LVMI) in asymptomatic hypertensive subjects.
  • To prospectively investigate the incidence of cardiovascular disease (CVD) in relation to CRP levels and LVMI.
  • To determine if CRP provides additional prognostic information for CVD events in hypertensive patients with or without LVH.

Main Methods:

  • Cross-sectional analysis of 629 asymptomatic hypertensive subjects (mean age 62 years) stratified by baseline CRP levels (<1, 1-2, >2 mg/L).
  • Prospective follow-up (mean 32 months) to assess incident cardiovascular disease (CVD).
  • Multivariate analysis, Kaplan-Meier survival analysis, and Cox regression were used to evaluate associations between CRP, LVMI, LVH, and CVD events.

Main Results:

  • LVMI increased significantly with higher CRP levels in both men and women (p<0.001 and p=0.031, respectively).
  • Elevated CRP levels (≥1 mg/L) and the presence of LVH were associated with poorer event-free survival for CVD (p<0.01).
  • The combination of LVH and CRP ≥1 mg/L conferred a markedly higher risk of CVD events (adjusted hazard ratio 2.65, p<0.01).

Conclusions:

  • CRP levels are independently associated with LVMI in hypertensive individuals.
  • Elevated CRP is a significant predictor of future CVD events, particularly in patients with LVH.
  • Measuring CRP may enhance CVD risk stratification in hypertensive patients already assessed for LVH.

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