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Published on: January 7, 2013
Creatine kinase is associated with failure of hypertension treatment
Inge Oudman1, Preschana V Kewalbansingh, Irene van Valkengoed
1Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Insights
High creatine kinase levels are linked to treatment-resistant hypertension. This finding suggests creatine kinase may be a predictor of antihypertensive therapy failure, impacting patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Clinical Research
Background:
- Resistant hypertension poses a significant clinical challenge due to its high prevalence and mortality risk.
- Creatine kinase (CK) has been implicated in increasing blood pressure via enhanced sodium retention and cardiovascular contractility.
- A potential link between elevated CK levels and antihypertensive treatment failure was hypothesized.
Purpose of the Study:
- To investigate the association between resting serum creatine kinase levels and the failure of antihypertensive treatment.
- To determine if high creatine kinase is an independent predictor of uncontrolled hypertension despite treatment.
Main Methods:
- A cross-sectional study analyzed a random, multiethnic population sample (N=1444) aged 34-60 years.
- Multinomial logistic regression was employed to assess the primary outcome: the association between serum creatine kinase and treated uncontrolled hypertension.
- Serum creatine kinase levels were stratified into tertiles for comparative analysis.
Main Results:
- Hypertension prevalence increased significantly across increasing creatine kinase tertiles (P<0.001).
- Treatment failure occurred in 72.9% of participants in the highest CK tertile versus 46.7% in the lowest tertile (P=0.004).
- Creatine kinase emerged as a primary predictor of treatment failure (aOR 3.7), independent of other demographic and clinical factors.
Conclusions:
- Elevated creatine kinase levels are significantly associated with the failure of antihypertensive therapy.
- This association warrants further investigation to potentially refine treatment strategies for difficult-to-treat hypertension.
Background:
Failure of hypertension treatment is a major clinical issue because of the high prevalence and the associated mortality risk. We have reported evidence that creatine kinase increases blood pressure through greater sodium retention and cardiovascular contractility, by rapidly providing ATP for these functions. Therefore, we hypothesized that high creatine kinase is associated with failure of antihypertensive treatment.
Method:
We analyzed a cross-sectional, random multiethnic sample of the general population (N = 1444), aged 34-60 years. The primary outcome was the independent association between resting serum creatine kinase and treated uncontrolled hypertension in the population, using multinomial logistic regression analysis.
Results:
Hypertension prevalence was, respectively, 26.8; 30.8; and 41.2% for the lowest (<88 IU/l) through the highest population creatine kinase tertile (>145 IU/l; P < 0.001). Treatment failed in 72.9% of participants within the highest creatine kinase tertile vs. 46.7% within the lowest tertile (P = 0.004). In logistic regression analysis, creatine kinase was the main predictor of treatment failure (adjusted odds ratio 3.7; 95% confidence interval 1.2-10.9), independent of age, sex, BMI, fasting glucose, ethnicity, or education level.
Conclusion:
Creatine kinase is associated with failure of antihypertensive therapy. Further investigations concerning this association might help improve treatment strategies for difficult-to-treat hypertension.
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