Lack of Independent Association Between C-Reactive Protein and Central Aortic Hemodynamics in Black Africans with High Risk of Cardiovascular Disease

Abstract

As the independent relationship between C-reactive protein (CRP) concentrations and central aortic blood pressures (BP) in populations with high CRP concentrations is uncertain, we aimed to evaluate this question in a community sample, 57% with CRP concentrations >3 mg/l (high cardiovascular risk). Central aortic hemodynamics (applanation tonometry, SphygmoCor software) and serum ultrasensitive-CRP concentrations were assessed in 836 randomly recruited participants from an urban developing community of African ancestry. Log CRP was strongly correlated with age, steady-state pressures (indexed by mean arterial pressure (MAP)), indexes of adiposity, central systolic BP (SBPc), central pulse pressure (PPc), the augmented (reflected) (AP) and forward (P1) pressure wave components of PPc, aortic pulse wave velocity (PWV), and the effective reflecting distance (ERD) (P < 0.0001 for all). Moreover, before adjustments SBPc, PPc, AP, P1, PWV, and ERD increased incrementally across low, moderate and high risk categories of CRP (P < 0.0001). However, in multivariate models with adjustments for confounders, no independent association between CRP and SBPc, PPc, AP, P1, PWV, or ERD was noted (P > 0.10 for all) and multivariate adjusted central hemodynamic variables were similar in participants with low, moderate, or high risk CRP concentrations. The lack of independent relationship between CRP concentrations and central aortic hemodynamics was reproduced in normotensives, hypertensives, men, women, lean and overweight/obese participants, and in participants lesser or ≥ 60 years of age. Even in communities with prevalent high CRP concentrations, low-grade inflammation as indexed by CRP, does not independently account for increases in aortic PP, the component waves, or the determinants of PPc.