Short-term changes in hsCRP and NT-proBNP levels in hypertensive emergencies

Hypertension is associated with high cardiovascular risk. Both hsCRP and NT-proBNP also have been associated with elevated cardiovascular risk, at least in the long term. Much less is known about the short-term changes in these markers, for example, in hypertensive emergencies. In 59 consecutive patients with hypertensive emergencies, hsCRP and NT-proBNP were measured at baseline and at days 3-4 and 7-10 after admission. All patients with hsCRP levels above 10 mg/l during the study were excluded due to possible infections. We found elevated levels of hsCRP at baseline with a significant decline on days 3-4 (day 0: median 2.53 mg/l, days 3-4: median 1.65 mg/l [p<0.01 vs. baseline], days 7-10 median: 2.00 mg/l). Women had higher hsCRP levels than men, and patients with hypertensive cardiomyopathy by echocardiographic criteria had significantly higher hsCRP levels compared with patients without hypertensive cardiomyopathy throughout the study. NT-proBNP levels were clearly elevated at admission (median 158 ng/l) and declined highly significantly thereafter (day 3-4: 61 ng/l, p<0.0001 vs. baseline; day 7-10: 76 ng/l, p<0.0001 vs. baseline). Patients with hypertensive cardiomyopathy had higher NT-proBNP levels compared with those patients without. In hypertensive emergencies, NT-proBNP levels correspond to levels described in acute coronary syndrome and decline significantly under antihypertensive therapy. In addition, we found an acute decline in hsCRP in the short term after hypertensive emergencies. These data may have importance in the clinical setting of hypertensive emergencies and in the interpretation of epidemiological data.