M
Matti Narkia
Guest
A new study published in JAMA in December 10 suggests that hypertension may be an inflammatory
disease. The study found that CRP was significantly associated with an increased (52% higher) risk
of developing hypertension. The study is
Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM. C-reactive protein and the risk of
developing hypertension. JAMA. 2003 Dec 10;290(22):2945-51. PMID: 14665655 [PubMed - indexed for
MEDLINE] <URL:http://jama.ama-assn.org/cgi/content/abstract/290/22/2945> <URL:http://www.ncbi.nlm.n-
ih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=14665655&dopt=Abstract>
Abstract:
"CONTEXT: Although it has been hypothesized that hypertension is in part an inflammatory
disorder, clinical data linking inflammation with incident hypertension are scarce. OBJECTIVE:
To examine whether C-reactive protein levels, a marker of systemic inflammation, are
associated with incident hypertension. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort
study that began in 1992 of 20 525 female US health professionals aged 45 years or older who
provided baseline blood samples with initially normal levels of blood pressure (BP) (systolic
BP <140 mm Hg and diastolic BP <90 mm Hg, and no history of hypertension or antihypertensive
medications) and then followed up for a median of 7.8 years for the development of incident
hypertension. Plasma C-reactive protein levels were measured and baseline coronary risk
factors were collected. MAIN OUTCOME MEASURE: Incident hypertension, defined as either a new
physician diagnosis, the initiation of antihypertensive treatment, or self-reported systolic
BP of at least 140 mm Hg or a diastolic BP of at least 90 mm Hg. RESULTS: During follow-up,
5365 women developed incident hypertension. In crude models, the relative risks (RRs) and 95%
confidence intervals (CIs) of developing hypertension from the lowest (referent) to the
highest levels of baseline C-reactive protein were 1.00, 1.25 (95% CI, 1.14-1.40), 1.51 (95%
CI, 1.35-1.68), 1.90 (95% CI,
1.72-2.11), and 2.50 (95% CI, 2.27-2.75) (linear trend P<.001). In fully adjusted models for
coronary risk factors, the RRs and 95% CIs were 1.00, 1.07 (95% CI, .95-1.20), 1.17 (95% CI,
1.04-1.31), 1.30 (95% CI,
2.17-1.45), and 1.52 (95% CI, 1.36-1.69) (linear trend P<.001). C-reactive protein was
significantly associated with an increased risk of developing hypertension in all prespecified
subgroups evaluated, including those with very low levels of baseline BP, as well as those
with no traditional coronary risk factors. Similar results were found when treating C-reactive
protein as a continuous variable and controlling for baseline BP. CONCLUSION: C- reactive
protein levels are associated with future development of hypertension, which suggests that
hypertension is in part an inflammatory disorder."
Comments in
Higher C-Reactive Protein Levels Appear Associated with Increased Risk of Incident Hypertension <UR-
L:http://www.docguide.com/news/content.nsf/news/C01D64482295515185256DF9004D5270?OpenDocument&c=Hyp-
ertension&count=10> ( http://tinyurl.com/2gtej )
"Levels of C-reactive protein appear to be associated with an increased risk of hypertension
that is independent of baseline blood pressure levels and coronary risk factors, according to
findings from the Women's Health Study.
"These data suggest that inflammation may have a potentially important role in the development
of hypertension," reports Howard D. Sesso, ScD, MPH, of Brigham and Women's Hospital, Boston,
Massachusetts, United States, and colleagues. The researchers analysed baseline blood pressure
and coronary risk factors as well as baseline C-reactive protein levels compared with these
levels over a median of 7.8 years of follow up in 20,525 female healthcare professionals, 45
years or older. The cohort had baseline blood pressure of less than 140 mm Hg systolic and 90 mm
Hg diastolic and had no history of hypertension or the use of antihypertensive treatment.
[...]
When fully adjusting for coronary risk factors, the relative risk of incident hypertension
ranged from 1.07 for C-reactive protein levels of 0.44 to 0.89 mg/L to 1.52 for C-reactive
protein levels over 3.5 mg/L, compared with women with C-reactive protein levels below 0.43
mg/L. Increased levels of C-reactive protein were associated with increased risk of incident
hypertension in all subgroup evaluations."
and
Hypertension May Be Inflammatory Disease-Study Wed 10 December, 2003 17:13
<URL:http://www.reuters.co.uk/newsArticle.jhtml?type=healthNews&storyID=3971292§ion=news>
"... The researchers monitored 20,525 women aged 45 or older for high blood pressure over eight
years. Those who had high levels of the protein at the start had a 52 percent higher risk of
developing hypertension, the study found.
"This significant increase in risk was present even among those with very low levels of blood
pressure when they entered the study, and was also seen among healthier women without many
traditional coronary risk factors," Sesso said.
The article said that researchers already have found that inflammation plays a crucial role in
the development of heart disease and that inflammation can be measured easily with a simple and
inexpensive blood test for the telltale protein.
"We already know that (the protein) is a stronger predictor of heart attack risk than
cholesterol," said Paul Ridker, another author.
"The current data linking (it) to the development of high blood pressure tells us that
inflammation may play a major role in the development of vascular disease throughout the body.
If we can predict and prevent the onset of high blood pressure, then we will be well on our way
toward the prevention of stroke," he said."
The next step, Ridker added, was "to find out whether therapies targeting inflammation itself
can be used to reduce the risk of these devastating events."
--
Matti Narkia
disease. The study found that CRP was significantly associated with an increased (52% higher) risk
of developing hypertension. The study is
Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM. C-reactive protein and the risk of
developing hypertension. JAMA. 2003 Dec 10;290(22):2945-51. PMID: 14665655 [PubMed - indexed for
MEDLINE] <URL:http://jama.ama-assn.org/cgi/content/abstract/290/22/2945> <URL:http://www.ncbi.nlm.n-
ih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=14665655&dopt=Abstract>
Abstract:
"CONTEXT: Although it has been hypothesized that hypertension is in part an inflammatory
disorder, clinical data linking inflammation with incident hypertension are scarce. OBJECTIVE:
To examine whether C-reactive protein levels, a marker of systemic inflammation, are
associated with incident hypertension. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort
study that began in 1992 of 20 525 female US health professionals aged 45 years or older who
provided baseline blood samples with initially normal levels of blood pressure (BP) (systolic
BP <140 mm Hg and diastolic BP <90 mm Hg, and no history of hypertension or antihypertensive
medications) and then followed up for a median of 7.8 years for the development of incident
hypertension. Plasma C-reactive protein levels were measured and baseline coronary risk
factors were collected. MAIN OUTCOME MEASURE: Incident hypertension, defined as either a new
physician diagnosis, the initiation of antihypertensive treatment, or self-reported systolic
BP of at least 140 mm Hg or a diastolic BP of at least 90 mm Hg. RESULTS: During follow-up,
5365 women developed incident hypertension. In crude models, the relative risks (RRs) and 95%
confidence intervals (CIs) of developing hypertension from the lowest (referent) to the
highest levels of baseline C-reactive protein were 1.00, 1.25 (95% CI, 1.14-1.40), 1.51 (95%
CI, 1.35-1.68), 1.90 (95% CI,
1.72-2.11), and 2.50 (95% CI, 2.27-2.75) (linear trend P<.001). In fully adjusted models for
coronary risk factors, the RRs and 95% CIs were 1.00, 1.07 (95% CI, .95-1.20), 1.17 (95% CI,
1.04-1.31), 1.30 (95% CI,
2.17-1.45), and 1.52 (95% CI, 1.36-1.69) (linear trend P<.001). C-reactive protein was
significantly associated with an increased risk of developing hypertension in all prespecified
subgroups evaluated, including those with very low levels of baseline BP, as well as those
with no traditional coronary risk factors. Similar results were found when treating C-reactive
protein as a continuous variable and controlling for baseline BP. CONCLUSION: C- reactive
protein levels are associated with future development of hypertension, which suggests that
hypertension is in part an inflammatory disorder."
Comments in
Higher C-Reactive Protein Levels Appear Associated with Increased Risk of Incident Hypertension <UR-
L:http://www.docguide.com/news/content.nsf/news/C01D64482295515185256DF9004D5270?OpenDocument&c=Hyp-
ertension&count=10> ( http://tinyurl.com/2gtej )
"Levels of C-reactive protein appear to be associated with an increased risk of hypertension
that is independent of baseline blood pressure levels and coronary risk factors, according to
findings from the Women's Health Study.
"These data suggest that inflammation may have a potentially important role in the development
of hypertension," reports Howard D. Sesso, ScD, MPH, of Brigham and Women's Hospital, Boston,
Massachusetts, United States, and colleagues. The researchers analysed baseline blood pressure
and coronary risk factors as well as baseline C-reactive protein levels compared with these
levels over a median of 7.8 years of follow up in 20,525 female healthcare professionals, 45
years or older. The cohort had baseline blood pressure of less than 140 mm Hg systolic and 90 mm
Hg diastolic and had no history of hypertension or the use of antihypertensive treatment.
[...]
When fully adjusting for coronary risk factors, the relative risk of incident hypertension
ranged from 1.07 for C-reactive protein levels of 0.44 to 0.89 mg/L to 1.52 for C-reactive
protein levels over 3.5 mg/L, compared with women with C-reactive protein levels below 0.43
mg/L. Increased levels of C-reactive protein were associated with increased risk of incident
hypertension in all subgroup evaluations."
and
Hypertension May Be Inflammatory Disease-Study Wed 10 December, 2003 17:13
<URL:http://www.reuters.co.uk/newsArticle.jhtml?type=healthNews&storyID=3971292§ion=news>
"... The researchers monitored 20,525 women aged 45 or older for high blood pressure over eight
years. Those who had high levels of the protein at the start had a 52 percent higher risk of
developing hypertension, the study found.
"This significant increase in risk was present even among those with very low levels of blood
pressure when they entered the study, and was also seen among healthier women without many
traditional coronary risk factors," Sesso said.
The article said that researchers already have found that inflammation plays a crucial role in
the development of heart disease and that inflammation can be measured easily with a simple and
inexpensive blood test for the telltale protein.
"We already know that (the protein) is a stronger predictor of heart attack risk than
cholesterol," said Paul Ridker, another author.
"The current data linking (it) to the development of high blood pressure tells us that
inflammation may play a major role in the development of vascular disease throughout the body.
If we can predict and prevent the onset of high blood pressure, then we will be well on our way
toward the prevention of stroke," he said."
The next step, Ridker added, was "to find out whether therapies targeting inflammation itself
can be used to reduce the risk of these devastating events."
--
Matti Narkia
