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[The prospective study of association between C-reactive protein and hypertension in community population]
Hong-hong Lu1, Zhi-rong Guo, Xiao-shu Hu
1Department of Endocrinology and Metabolism, Suzhou Municipal Hospital, Suzhou 215008, China.
Insights
High-sensitivity C-reactive protein (hs-CRP) levels are associated with an increased risk of developing hypertension. Elevated hs-CRP indicates inflammation, a key factor in hypertension development.
Area of Science:
- Biomarkers of Inflammation
- Cardiovascular Disease Epidemiology
- Hypertension Pathophysiology
Context:
- Inflammation is increasingly recognized as a contributor to cardiovascular diseases.
- High-sensitivity C-reactive protein (hs-CRP) is a sensitive marker of systemic inflammation.
- Understanding the role of inflammation in hypertension development is crucial for prevention strategies.
Purpose:
- To investigate the association between baseline hs-CRP levels and the incidence of hypertension in a Chinese cohort.
- To determine if hs-CRP predicts future hypertension risk, independent of other risk factors.
Summary:
- A cohort study of 2035 Chinese adults analyzed the relationship between baseline hs-CRP levels and hypertension incidence over a median follow-up of 6.39 years.
- Participants were categorized into quartiles based on hs-CRP levels (<1.3, 1.3-1.9, 2.0-3.2, and ≥3.3 mg/L).
- Hypertension incidence increased progressively with higher hs-CRP quartiles. Relative risks (RR) for hypertension were elevated in higher hs-CRP groups, even after adjusting for multiple confounders. Stratified analysis by baseline blood pressure further supported this association, with significantly higher RRs observed in individuals with lower baseline blood pressure and higher hs-CRP levels.
Impact:
- Findings suggest that inflammation, as indicated by hs-CRP, plays a significant role in the development of hypertension.
- Elevated hs-CRP may serve as an early warning marker for hypertension risk.
- This research highlights the importance of considering inflammatory processes in hypertension prevention and management.
Objective:
The aim was to explore the association between high-sensitivity C-reactive protein level at baseline and hypertension in follow-up periods in a Chinese cohort.
Methods:
We analyzed data from a cohort established in "Prevention of metabolic syndrome and multi-metabolic disorders in Jiangsu province" in April 2000. A follow-up investigation was carried out for those whose follow up time met 5 years in June 2006. A total of 2035 persons completed investigation and hs-CRP was tested. Subjects with normal baseline blood pressure were classified into four groups(514, 498, 515 and 508 subjects in each group) according to quartiles of hs-CRP level (<1.3, 1.3-1.9, 2.0-3.2 and ≥ 3.3 mg/L). The relationship between the risk of hypertension and baseline level of hs-CRP were analyzed using Cox proportional hazards regression model.
Results:
The median of follow up time was 6.39 years among the 2035 subjects (926 males and 1109 females). Hypertension incidence was 2378/100 000 person-years, 2942/100 000 person-years, 3693/100 000 person-years and 4390/100 000 person-years in hs-CRP < 1.3, 1.3-1.9, 2.0-3.2 and ≥ 3.3 mg/L groups respectively. Compared to the group of hs-CRP < 1.3 mg/L, the relative risk (RR) (95%CI) of hypertension in groups of hs-CRP 1.3-1.9, 2.0-3.2 and ≥ 3.3 mg/L was 1.22 (0.87-1.72), 1.43 (1.03-2.00), 1.70 (1.21-2.41) respectively, adjusted for sex, age, baseline blood pressure, BMI, smoking, alcohol drinking, physical activity and family history of myocardial infarction and diabetes.When stratified by quartiles of baseline blood pressure, the incidence of hypertension in each group increased with level of hs-CRP.In the group whose baseline SBP < 110 mm Hg (1 mm Hg = 0.133 kPa) , compared to the group of hs-CRP < 1.3 mg/L, RR (95%CI) were 2.24 (1.32-4.03), 2.57 (1.57-4.57) and 3.57 (2.54-5.90) in hs-CRP 1.3-1.9, 2.0-3.2 and ≥ 3.3 mg/L groups respectively.In the group whose baseline DBP < 65 mm Hg, RR (95%CI) were 1.78 (1.03-3.24), 2.74 (1.63-4.93) and 4.13 (2.35-7.27) respectively.
Conclusion:
Inflammation was an important process in the development of hypertension.
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