J-014 C-REACTIVE PROTEIN, AN INFLAMMATION MARKER, PREDICTS THE DEVELOPMENT OF HYPERTWNSION AND ISCHEMIC STROKE IN TAIWANESE POPULATION

Abstract

Background Inflammation has been associated with cardiovascular events and mortality, using C-reactive protein (CRP) as a marker. However, few studies simultaneously examined its short-term effect for the development of hypertension and long-term effect for future ischemic stroke. We examined the hypotheses on whether CRP can independently predict the development of hypertension and ischemic stroke (IS) in the Chinese population in Taiwan. Methods The study population was those recruited in cycle 2 (1990–1993) of the CVDFACTS study and was followed to 1994–1997 for development of hypertension and to Dec 31, 2002 for future ischemic stroke. A total of 2113 normal blood pressure residents without diabetes were enrolled for studying incident hypertension and 3658 free of stroke individuals were recruited for future ischemic stroke. Three datasets were used to ascertain the status of ischemic stroke, including national health insurance dataset, death registry, and medical records. Results During the 3-year follow-up for development of hypertension and an average of 10.6-year follow-up for future ischemic stroke, there were 145 incident hypertension and 148 first-ever ischemic stroke events, respectively. The incidence rates of hypertension by tertiles of CRP were 3.1%, 6.3%, and 11.0% in that order (p for trend <.0001). The IS incidence rates by tertiles were 1.15, 4.04, and 6.54 per 1000 person-year (p for trend<.0001). In multivariate model baseline CRP significantly predicted incidence of hypertension and future IS. Comparing with the lowest group, the relative risks for incident hypertension were 1.35 (0.80–2.29) and 1.72 (1.0–2.88) for the middle and upper tertiles, respectively. Those for the future ischemic stroke were 1.87 (1.03–3.41) and 1.97 (1.08–3.61). Conclusions Inflammation may precede the development of hypertension and ischemic stroke in the Taiwanese population.