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| Associations between high-sensitivity C-reactive protein and the risk of developing hypertension |
| 경북대학교병원 순환기 내과¹ , 경북대학교 예방의학교실² , 경북대학교병원 내분비 내과³ |
| 이장훈¹, 채성철¹ , 이상혁¹ , 배명환¹ , 류현민¹ , 양동헌¹ , 박헌식¹ , 조용근¹ , 전재은¹ , 박의현 ¹ , 감신² , 천병렬² , 김정국³ , 이인규³ , 김보완³ |
Background: It has been hypothesized that hypertension may be in part an inflammatory disorder. However, limited clinical data are available about the association between inflammation and the risk of developing hypertension. The purpose of this study was to determine the association of serum high sensitive C-reactive protein (hs-CRP), a marker of systemic inflammation, with the risk of developing hypertension in nonhypertensive individuals. Methods: Study subjects were 710 Koreans (263 males; mean age = 54.5±9.1 year-old) in a rural area in Daegu city, Korea. They were enrolled in the 2003 Daegu City Hypertension-Diabetes Survey from August to November 2003 for a cohort study. Of these patients, 452 (63.7%) nonhypertensive individuals were finally analyzed in this study. Baseline levels of serum hs-CRP were measured by immunoturbidimetric assay. Primary endpoint was incident cases of hypertension, defined as either a new physician diagnosis or self-reports of newly initiated antihypertensive treatment. Results: Baseline hs-CRP levels were significantly higher in prehypertensive individuals compared to normotensive individuals (1.26±1.60 mg/L versus 0.94±1.32 mg/L, p=0.026). During the 5-year follow-up, 99 (21.9%) of 452 non-hypertensive individuals developed incident hypertension. The hs-CRP levels were significantly higher in patients with incident hypertension (1.05±1.40 mg/L versus 1.41±1.62 mg/L, p=0.027). In multivariate analysis log transformed hs-CRP (Odds ratio [OR] 2.038, 95% confidence interval [CI] 1.128–3.683; p=0.018) in addition to systolic blood pressure (OR 1.070, 95% CI 1.029–1.112; p=0.001) were independent predictors of developing hypertension after adjusting for age, gender, body mass index, diabetes mellitus, lipid profiles, diastolic blood pressure, status of smoking, frequency of exercise. The combination of systolic blood pressure and hs-CRP levels showed incremental prognostic value to predict incident hypertension. In fully adjusted models, the ORs (95% CI) of developing hypertension from lowest (referent) to the highest levels of hs-CRP were 1.0, 1.84 (0.94–3.59), 2.45 (1.26–4.76). Conclusions: This study provides evidence that baseline levels of hs-CRP are modestly associated with an increased risk of developing hypertension. These data suggest that inflammation may have a potentially important role in part in the development of hypertension.
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