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Published on: August 9, 2019
High-sensitivity C-reactive protein predicts microalbuminuria progression in essential hypertensive patients: a
Yan Yang1, Xiao-Feng Tang1, Yan Wang1
1Department of Cardiovascular Medicine, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine.
Insights
High-sensitivity C-reactive protein (hs-CRP) predicts microalbuminuria progression in hypertensive patients. Combined with traditional risk factors, hs-CRP significantly increases the risk of developing microalbuminuria.
Area of Science:
- Cardiology
- Nephrology
- Inflammation Research
Background:
- Hypertension is a major risk factor for cardiovascular and kidney disease.
- Microalbuminuria is an early marker of kidney damage in hypertensive individuals.
- Inflammatory markers like high-sensitivity C-reactive protein (hs-CRP) may play a role in disease progression.
Purpose of the Study:
- To investigate the independent effect of hs-CRP on microalbuminuria in hypertensive patients.
- To assess the combined impact of hs-CRP and traditional risk factors on microalbuminuria progression over 3 years.
Main Methods:
- Longitudinal study of 280 hypertensive adults, with 199 completing a 3-year follow-up.
- Measurement of baseline hs-CRP, traditional risk factors, and urinary albumin-to-creatinine ratio (ACR).
- Multivariate stepwise linear analysis to identify predictors of ACR and ACR change.
Main Results:
- Higher baseline hs-CRP levels were associated with increased ACR at follow-up (P=0.007).
- Baseline diabetes, SBP, log-transformed hs-CRP, and eGFR independently predicted ACR at follow-up.
- Diabetes and log-transformed hs-CRP predicted ACR change during follow-up.
- Combined risk factors including hs-CRP increased the risk of microalbuminuria progression.
Conclusions:
- Baseline hs-CRP is a significant predictor of microalbuminuria progression in essential hypertensive patients.
- The combination of hs-CRP with traditional cardiovascular risk factors amplifies the risk of developing microalbuminuria.
Objectives:
To determine the independent effect of high-sensitivity C-reactive protein (hs-CRP) and the combined effects of hs-CRP and other traditional risk factors on microalbuminuria in hypertensive patients during the 3-year follow-up period.
Methods And Results:
Baseline hs-CRP levels and other risk factors were measured in 280 adults in 2007. In the third year of examination, 199 patients (mean age 62.5 ± 9.5, men 59.3%) were approached for the measurement of microalbuminuria. The subjects were classified into two groups by the median of baseline hs-CRP. Compared to the patients with baseline hs-CRP below the median group ( n = 99, 50%), the group with baseline hs-CRP above the median ( n = 100, 50%) had higher urinary albumin-to-creatinine ratio (ACR) ( P = 0.007) at the end of follow-up period. ACR at the end of follow-up period was significantly correlated with baseline diabetes ( β = 0.342; P < 0.001), baseline SBP ( β = 0.148; P = 0.02), and baseline log-transformed hs-CRP ( β = 0.169; P = 0.01), while adversely correlated with baseline estimated glomerular filtration rate (eGFR) ( β = -0.163; P = 0.02) in multivariate stepwise linear analysis. In addition, ACR change during follow-up period was significantly correlated with baseline diabetes ( β = 0.359; P < 0.001) and baseline log-transformed hs-CRP ( β = 0.190; P = 0.004) in multivariate stepwise linear analysis. The combined effects of baseline hs-CRP and conventional risk factors, such as male sex, diabetes, smoking status, hyperlipidemia, hyperuricemia, and mildly reduced eGFR had a greater risk for microalbuminuria progression. There was no difference in eGFR changes during the follow-up period between two groups.
Conclusion:
Our findings offer a new piece of evidence on the predictive value of baseline hs-CRP for microalbuminuria progression in essential hypertensive patients, and highlight those who combined with traditional cardiovascular risk factors had a greater risk for developing microalbuminuria.
