Abstract P108: Stroke Incidence and High Sensitivity C-reactive Protein Among African Americans: The Jackson Heart Study

Abstract

In the United States, strokes are a leading cause of death and disabilities, especially for older adults; however, effective biological markers to predict stroke remain elusive. The objective of this study was to investigate the association between inflammation, as measured by high-sensitivity c-reactive protein (hs-CRP) and stroke incidence among African Americans (AA) enrolled in a community-based longitudinal observational study, the Jackson Heart Study.Baseline hs-CRP levels were categorized in quintiles: Quintile 1 (0.0084 mg/L); Quintile 2 (0.0085 - 0.0189 mg/L); Quintile 3 (0.0190 - 0.036 mg/L); Quintile 4 (0.037 - 0.0675 mg/L); Quintile 5 (≥ 0.0676 mg/L). Stroke risk factors/covariates were compared across hs-CRP tertiles. Continuous variables were compared using a one-way ANOVA, and a Chi-Square test was used for categorical variables. To determine whether baseline hs-CRP levels were associated with stroke incidence, Cox regression analyses were conducted to estimate hazard ratios (HRs) and 95% confidence intervals (CI).Results from the unadjusted model of the Cox regression indicates hs-CRP levels in quintile 2 (HR 1.48; 95% CI 0.96-2.29), quintile 3 (HR 1.44; 95% CI 0.93-2.24), and quintile 4 (HR 1.09; 95% CI 0.68-1.74) were not associated with stroke incidence when compared to quintile 1 (reference). Participants with the highest hs-CRP levels, quintile 5, were at an increased risk for stroke (HR 1.78; 95% CI 1.17-2.72) compared to the reference quintile. In a fully adjusted model including risk factors and mediators for stroke/hs-CRP (demographics, anthropometrics, health condition covariates, health behavioral risk factors, and cardiovascular disease history), the increased stroke risk incidence remained present for quintile 5 (HR 1.87; 95% CI 1.17-2.98) compared to reference quintile 1.Overall, these results corroborate previous studies’ findings in Black Americans that hs-CRP is associated with stroke incidence only at most severe levels. Although several studies have demonstrated higher hs-CRP in AAs, there have been a lesser association of hs-CRP and cardiovascular disease; hence, these findings provide new insights that hs-CRP l may not be a reliable predictor for stroke incidence among AAs.