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C-reactive protein and hypertension
11] Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA [2] Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA.
Insights
C-reactive protein (CRP) is a key biomarker for cardiovascular disease and hypertension. Elevated CRP levels predict cardiovascular events and hypertension development, and CRP actively contributes to vascular dysfunction.
Area of Science:
- Cardiovascular Medicine
- Inflammation Biology
- Hypertension Research
Background:
- C-reactive protein (CRP) is a well-established biomarker for cardiovascular disease (CVD).
- CRP levels are used to assess cardiovascular risk and guide therapy selection in intermediate-risk individuals.
- The role of CRP in hypertension is increasingly recognized.
Purpose of the Study:
- To review the multifaceted role of C-reactive protein (CRP) in the context of hypertension.
- To explore CRP's association with hypertension-related vascular damage and cardiovascular outcomes.
- To examine CRP's potential as a predictor of hypertension development and its direct role in vascular pathology.
Main Methods:
- Review of existing literature on C-reactive protein (CRP) and hypertension.
- Analysis of studies investigating CRP levels in hypertensive and normotensive individuals.
- Examination of experimental data on CRP's direct effects on vascular function and remodeling.
Main Results:
- In hypertensive individuals, CRP levels correlate with vascular stiffness, atherosclerosis, end-organ damage, and cardiovascular events.
- Some antihypertensive drugs may reduce CRP levels independently of blood pressure effects.
- Baseline CRP levels predict future hypertension development in normotensive individuals.
- CRP actively contributes to endothelial dysfunction, vascular stiffness, and elevated blood pressure.
- CRP is implicated in vascular and cardiac remodeling processes.
Conclusions:
- C-reactive protein (CRP) is a significant biomarker and active participant in hypertension pathogenesis.
- CRP's role extends beyond risk prediction to direct mediation of vascular dysfunction and remodeling.
- Further research into CRP-mediated inflammatory pathways may reveal novel therapeutic targets for hypertension and related vascular diseases.
Abstract:
C-reactive protein (CRP), the prototypical acute-phase reactant, is one of the most widely known biomarkers of cardiovascular disease. Circulating levels of CRP are clinically used to predict the occurrence of cardiovascular events and to aide in the selection of therapies based on more accurate risk assessment in individuals who are at intermediate risk. This paper reviews the role of CRP in hypertension. In hypertensive individuals, CRP levels associate with vascular stiffness, atherosclerosis and the development of end-organ damage and cardiovascular events. Data suggest that some anti-hypertensive medications may lower CRP levels in a manner independent of their effect on blood pressure. In individuals who are normotensive at baseline, CRP levels have been shown in multiple cohorts to foretell the development of hypertension on follow-up. Whether genetic variability that influences circulating levels of CRP independent of environmental and behavioral factors can also be used in a similar manner to predict the change in blood pressure and development of hypertension is controversial. In addition to its role as a biomarker, experimental studies have unraveled an active direct participation of CRP in the development of endothelial dysfunction, vascular stiffness and elevated blood pressure. CRP has also been implicated as a mediator of vascular remodeling in response to injury and cardiac remodeling in response to pressure overload. Emerging data may reveal novel vascular inflammatory pathways and identify new targets for treatment of vascular pathology.
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