C-reactive protein as a predictor of hypertension in the Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS) cohort
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B M Y Cheung1, K L Ong, A W K Tso
1Department of Medicine, University of Hong Kong, Hong Kong. mycheung@hku.hk
Insights
High C-reactive protein (CRP) levels predict hypertension development. Genetic variations in the CRP gene influence CRP levels but not hypertension risk in this population.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Inflammation Research
Background:
- Inflammation is implicated in hypertension development.
- The causal role of C-reactive protein (CRP) in hypertension is not fully understood.
- Investigating genetic factors, like CRP gene single-nucleotide polymorphisms (SNPs), offers insight into hypertension etiology.
Purpose of the Study:
- To examine the association between circulating CRP levels and hypertension.
- To determine if CRP gene SNPs influence plasma CRP levels and hypertension risk.
Main Methods:
- Plasma CRP levels and genotypes of nine CRP gene SNPs were analyzed in 1925 subjects.
- Longitudinal follow-up assessed hypertension development in 1115 initially normotensive individuals.
- Statistical analyses correlated CRP levels and SNPs with incident hypertension.
Main Results:
- Elevated plasma CRP was independently associated with an increased risk of developing hypertension.
- Six CRP gene SNPs significantly correlated with plasma CRP levels.
- No significant association was found between CRP gene SNPs and blood pressure or hypertension incidence.
Conclusions:
- Plasma CRP levels are a significant predictor of future hypertension.
- While CRP gene variants affect CRP levels, they do not appear to directly influence hypertension risk in this cohort.
- Plasma CRP, rather than CRP gene SNPs, is more strongly related to hypertension risk.
Abstract:
Inflammation contributes to the development of hypertension. Whether C-reactive protein (CRP) has a causal role in hypertension remains unknown. We studied the relationship between circulating CRP levels and hypertension. The role of single-nucleotide polymorphisms (SNPs) in the CRP gene as determinants of its plasma levels and the propensity to develop hypertension was investigated. Plasma CRP and genotypes of nine SNPs were determined in 1925 unrelated subjects from the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 (CRISPS-2) in 2000-2004. Among 1378 subjects normotensive in CRISPS-2, 1115 subjects had been followed up in CRISPS-3 after a median interval of 5.3 years, 236 of whom had developed hypertension. Plasma CRP was independently associated with the development of hypertension in CRISPS-3 (odds ratio per quartile=1.26, P=0.010). Six SNPs were associated with plasma CRP (all P<0.001). However, none of the SNPs was significantly associated with blood pressure, prevalent or incident hypertension, or change in blood pressure. In conclusion, plasma CRP predicts the development of hypertension. Genetic variants in the CRP gene are significantly associated with plasma CRP but not with hypertension. The future risk of hypertension is therefore more related to plasma CRP than SNPs in the CRP gene in this population.
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