High sensitivity C-reactive protein as an independent risk factor for essential hypertension

Background: C-reactive protein (CRP), one of the hepatic acute phase reactants, has been associated with decreased endothelium-dependent relaxation, a potential risk factor for hypertension. However, the relationship between CRP and hypertension has not been well elucidated. The aim of this study is to assess whether circulating levels of CRP are independently related to essential hypertension. Methods: We evaluated the relationship between high sensitivity CRP with blood pressure (BP) and several cardiovascular risk factors in a cross-sectional survey of 8347 apparently healthy Korean persons. The CRP was measured by nephelometry. Results: The subjects consisted of 4813 men and 3534 women, aged greater than or equal to20 years. Mean (SD) age and CRP level of the population were 47.1 (11.5) years and 1.12 (1.72) mg/L. Overall hypertension prevalence was 34%. There was a significant positive association between BP and the CRP level (P <.0001). After adjustment for age, sex, fasting blood sugar, triglyceride, low-density lipoprotein, body mass index, waist-hip ratio, high-density lipoprotein, the prevalence of hypertension by CRP was 1.267 (95% confidence interval [CI] 1.079-1.487, P =.004), 1.253 (95% Cl 1.062-1.477, P =.007), and 1.451 (95% CI 1.231-1.711, P <.001) times higher in subjects in the second, third, and fourth quartiles of CRP, as compared to subjects in the first quartile. Conclusions: Our results suggest that the CRP level may be an independent risk factor for the development of hypertension in Korean persons. However, because of the cross-sectional nature of our study, this finding should be confirmed in prospective cohort studies, aimed at elucidating the role of CRP in the prediction, diagnosis, and management of hypertension. Am J Hypertens 2003;16: 429-433 (C) 2003 American Journal of Hypertension, Ltd.