Association between C-reactive protein and blood pressure in a cohort of elderly Muscovites: epidemiological study data
https://doi.org/10.15829/1728-8800-2012-4-65-69
Abstract
Background. The elevation of blood pressure (BP) affects the development of vascular inflammation. At the same time, it has been suggested that inflammation itself could be an independent risk factor (RF) of arterial hypertension (AH) development.
Aim. To investigate whether the association between increased levels of C-reactive protein (CRP) and AH is independent from classical RFs.
Material and methods. The data were obtained during a crosssectional survey of 1876 Muscovites (47,9% men) aged ≥55 years, who participated in the prospective study “Stress, Ageing, and Health in Russia”. In all participants, socio-demographic characteristics, health behaviours, parameters of anthropometry and rest electrocardiography (ECG) were assessed. The levels of BP and blood lipids were also measured. The outcome variable was an increase in CRP levels (>3 mg/l). Statistical methods included logistic regression; the risk estimates were presented as odds ratios (OR) and 95% confidence intervals (CI).
Results. There was a positive link between AH and CRP levels of >3 mg/l. After adjustment for age and sex, OR of increased CRP levels in hypertensive participants vs. their AH-free peers was 1,688 (95% CI 1,323-2,154; p=0,0001). In the final model (adjustment for age, sex, educational level, smoking, alcohol consumption, abdominal obesity, high atherogenicity index, and coronary heart disease, CHD), this effect remained statistically significant (OR 1,450; 95% CI 1,127-1,864; p=0,004).
Conclusion. In elderly Muscovites, a positive association between increased CRP levels and the elevation of BP was independent from RFs and CHD.
About the Authors
S. A. ShalnovaRussian Federation
V. A. Zhukova
Russian Federation
V. A. Metelskaya
Russian Federation
A. D. Deev
Russian Federation
M. B. Khudyakov
Russian Federation
A. L. Aleksandri
Russian Federation
Yu. A. Balanova
Russian Federation
A. V. Kapustina
Russian Federation
V. V. Konstantinov
Russian Federation
S. K. Kukushkin
Russian Federation
E. V. Platonova
Russian Federation
M. A. Shkolnikova
Russian Federation
N. V. Kiseleva
Russian Federation
References
1. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003; 107: 499-511.
2. Morrow DA, Lemos JA. Benchmarks for the Assessment of Novel Cardiovascular Biomarkers. Circulation 2007; 115: 949-52.
3. Rohde LE, Hennekens CH, Ridker PM. Survey of C-reactive protein and cardiovascular risk factors in apparently healthy men. Am J Cardiol 1999; 84: 1018-22.
4. Chae CU, Lee RT, Rifai N, Ridker PM. Blood pressure and inflammation in apparently healthy men. Hypertension 2001; 38: 399-403.
5. Savoia C, Schiffrin EL. Inflammation and hypertension. Curr Opin Nephrol Hypertens 2006; 15: 152-8.
6. Sesso H D, Burning G E, Rafai N, et al. C-reactive protein and the risk of development hypertension. JAMA 2003; 290: 2945-51.
7. Sung KC, Suh JY, Kim BS, et al. High sensitivity C-reactive protein as an independent risk factor for essential hypertension. Am J Hypertens 2003; 16: 429-33.
8. Li JJ. Inflammation in hypertension: primary evidence. Chin Med J 2006; 119: 1215-21.
9. Cachofeiro V, Miana M, HerasN, et al. Inflammation: A Link Between Hypertension and Atherosclerosis. Current Hypertension Reviews 2009; 5: 40-8.
10. Verma S, Wang CH, Li SH, et al. A self-fulfilling prophecy: C-reactive protein attenuates nitric oxide production and inhibits angiogenesis. Circulation 2002; 106: 913-9.
11. Venugopal SK, Devaraj S, Yuhanna I, et al. Demonstration that C-reactive protein decreases eNOS expression and bioactivity in human aortic endothelial cells. Circulation 2002; 106: 1439-41.
12. Verma S, Li SH, Badiwala MV, et al. Endothelin antagonism and interleukin-6 inhibition attenuate the proatherogenic effects of C-reactive protein. Circulation 2002; 105: 1890-6.
13. Wang CH, Li SH, Weisel RD, et al. C-reactive protein upregulates angiotensin type 1 receptors in vascular smooth muscle. Circulation 2003; 107: 1783-90.
14. Devaraj S, Xu DY, Jialal I. C-reactive protein increases plasminogen activator inhibitor-1 expression and activity in human aortic endothelial cells: implications for the metabolic syndrome and atherothrombosis. Circulation 2003; 107: 398-404.
15. Cottone S, Mule G, Nardi E, Vadalа A, et al. Relation of C-Reactive Protein to Oxidative Stress and to Endothelial Activation in Essential Hypertension. AJH 2006; 19: 313-8.
16. Shkolnikova M, Shalnova S, Shkolnikov V. Biological mechanisms of disease and death in Moscow: rationale and design of the survey on Stress Aging and Health in Russia (SAHR) BMC Public Health 2009; 9: 293.
17. Alberti KG, Zimmet P, Shaw J, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity, Circulation 2009; 120(16): 1640-5.
18. Shalnova SA, Deev AD, Vikhireva OV, et al. Prevalence of arterial hypertension in Russia. Awareness, treatment, control. Disease prevention and health ptomotion. 2001; 2: 3-7. Russian (Шальнова С.А., Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертонии в России. Информированность, лечение, контроль. Профил забол укреп здор 2001; 2: 3-7).
19. Burt VL, Cutler JA, Higgins M, et al. Trends in the prevalence, awareness. Treatment, and control of hypertension in the adult US population., Data from the health examination surveys, 1960 to 1991. Hypertension 1995; 26: 60-9.
20. Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Study, 1988-1991. Hypertension 1995; 25: 305-13.
21. Lakoski SG, Cushman M, Palmas W, et al. The Relationship Between Blood Pressure and C-Reactive Protein in the Multi-Ethnic Study of Atherosclerosis (MESA). JACC 2005; 46: 1869-74.
22. Stamler J, Stamler R, Neaton J. Blood pressure, systolic and diastolic, and cardiovascular risks. Arch Intern Med 1993; 153: 598-615.
23. Kannel W, Gordon T, Schwartz M. Systolic versus diastolic blood pressure and risk of coronary heart disease. The Framingham study. Am J Cardiol 1971; 27: 335-46.
24. Skoog T, Dichtl W, Boquist S, et al. Plasma tumour necrosis factor-alpha and early carotid atherosclerosis in healthy middle-aged men. Eur Heart J 2002; 23: 376-83.
25. Dawson S, Henney A. The status of PAI-1 as a risk factor for arterial and thrombotic disease: a review. Atherosclerosis 1992; 95: 105-10.
Review
For citations:
Shalnova S.A., Zhukova V.A., Metelskaya V.A., Deev A.D., Khudyakov M.B., Aleksandri A.L., Balanova Yu.A., Kapustina A.V., Konstantinov V.V., Kukushkin S.K., Platonova E.V., Shkolnikova M.A., Kiseleva N.V. Association between C-reactive protein and blood pressure in a cohort of elderly Muscovites: epidemiological study data. Cardiovascular Therapy and Prevention. 2012;11(4):65-69. (In Russ.) https://doi.org/10.15829/1728-8800-2012-4-65-69