C-reactive Protein Predicts Systolic Blood Pressure and Pulse Pressure but not Diastolic Blood Pressure: the Cardiovascular Disease Risk Factors Two-Township Study

Abstract

Inflammation has been associated with cardiovascular events and mortality, using C-reactive protein (CRP) as a marker. We examined whether the baseline serum concentration of CRP can independently predict the development of hypertension or future systolic or diastolic blood pressure (BP) in a community-based population in Taiwan. A study population sample was recruited in cycle 2 (1990-1993) of the CardioVascular Disease risk FACtors Two-township Study (CVDFACTS) and was followed to 1994-1997. A total of 2,113 nondiabetic adults with normal BP were enrolled for the study of incident hypertension. Hypertension was defined as a systolic blood pressure (SBP) ≥ 140 mm Hg, a diastolic blood pressure (DBP) ≥ 90 mm Hg, or the use of antihypertensive drugs. Cox regression and linear regression analyses were used to evaluate the association between baseline serum concentrations of CRP measured with a high-sensitivity assay and the development of hypertension and future SBP/DBP and pulse pressure (PP). During the follow-up period of a median of 3.27 years, 145 participants developed incident hypertension. The incidence rates of hypertension by tertile of increasing CRP were 9.3, 19.0, and 33.0 per 1,000 person-years (P for trend < 0.01). In the multivariate model adjusted for age, gender, and prehypertension, baseline CRP remained significantly predictive of incident hypertension. The concentration of CRP was associated with SBP and PP, but not with DBP. Inflammation is associated with future SBP in the Taiwanese population.