Journal of the American Society of Hypertension
Volume 3, Issue 4 , Pages 260-266, July 2009

C-reactive protein among community-dwelling hypertensives on single-agent antihypertensive treatment

  • Tibor Fulop, MD

      Affiliations

    • Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
    • Corresponding Author InformationCorresponding author: Tibor Fulop, MD, University of Mississippi Medical Center, Department of Internal Medicine, Division of Nephrology, 2500 North State Street, Jackson, Mississippi 39216. Tel: 601-984-5670; fax: 601-984-5765.
    • ,
  • Andrew D. Rule, MD

      Affiliations

    • Department of Internal Medicine, Mayo Clinic Foundation, Rochester, Minnesota, USA
    • ,
  • Darren W. Schmidt, MD

      Affiliations

    • Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
    • ,
  • Heather J. Wiste, BA

      Affiliations

    • Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
    • ,
  • Kent R. Bailey, PhD

      Affiliations

    • Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
    • ,
  • Iftikhar J. Kullo, MD

      Affiliations

    • Department of Internal Medicine, Mayo Clinic Foundation, Rochester, Minnesota, USA
    • ,
  • Gary L. Schwartz, MD

      Affiliations

    • Department of Internal Medicine, Mayo Clinic Foundation, Rochester, Minnesota, USA
    • ,
  • Thomas H. Mosley Jr., PhD

      Affiliations

    • Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
    • ,
  • Eric Boerwinkle, PhD

      Affiliations

    • Institute of Molecular Medicine and Human Genetics Center, Houston, Texas, USA
    • ,
  • Stephen T. Turner, MD

      Affiliations

    • Department of Internal Medicine, Mayo Clinic Foundation, Rochester, Minnesota, USA

Received 14 February 2009; accepted 27 March 2009. published online 20 May 2009.

Abstract 

C-reactive protein (CRP) is a predictor of adverse cardiovascular outcomes. The effect of antihypertensive therapy on CRP levels is largely unknown. We undertook a cross-sectional study of CRP levels among participants with primary hypertension on single-agent antihypertensive therapy in the community-based biracial Genetic Epidemiology Network of Arteriopathy cohort. Linear regression models were used to assess the association of antihypertensive medication class with log-transformed CRP after adjustment for age, gender, ethnicity, body mass index, smoking, diabetes, hydroxymethylglutaryl CoA reductase inhibitor use, achieved blood pressure control (<140/90mm Hg), serum creatinine and urine albumin-to-creatinine ratios. There were 662 participants in the cohort taking single-agent therapy for hypertension. Median CRP levels differed across participants: 0.40mg/dL for those on diuretics, 0.34mg/dL on calcium-channel blockers, 0.25mg/dL on beta-blockers and 0.27mg/dL on renin-angiotensin-aldosterone system (RAAS) inhibitors (P < .001). With multivariable adjustment, the group on RAAS inhibitors had a 20% lower mean CRP on average than the group on diuretics (P=.044), differences between other medication classes were not apparent. Heart rate had a strong association with CRP (P < .001). Antihypertensive medication class may influence inflammation, particularly in patients on RAAS inhibitors.

Keywords: Diuretics, inflammation, RAAS inhibitors, sibships

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 This study was supported by the National Institute of Health Grants Nos. U01 HL 54464, U01 HL 54457, U01 HL 54463, U01 HL 54481, and R01 AR 30582 and clinical revenue support of the University of Mississippi Medical Center.

 Conflict of interest: none.

PII: S1933-1711(09)00044-8

doi:10.1016/j.jash.2009.03.003

Journal of the American Society of Hypertension
Volume 3, Issue 4 , Pages 260-266, July 2009

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