CLINICAL RESEARCH: ATHEROSCLEROSIS
The Relationship Between Blood Pressure and C-Reactive Protein in the Multi-Ethnic Study of Atherosclerosis (MESA)
Susan G. Lakoski, MD, MS*,*,
Mary Cushman, MD, MSc ,
Walter Palmas, MD, MS ,
Roger Blumenthal, MD, FACC||,
Ralph B. D’Agostino, Jr, PhD and
David M. Herrington, MD, MHS, FACC*
* Department of Internal Medicine/Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
Departments of Medicine and Pathology, University of Vermont, Burlington, Vermont
Department of Medicine, Columbia University, New York, New York
|| Ciccarone Preventive Cardiology Center, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Manuscript received May 6, 2005;
revised manuscript received July 11, 2005,
accepted July 18, 2005.
* Reprint requests and correspondence: Dr. Susan G. Lakoski, Division of Internal Medicine/Cardiology, Medical Center Boulevard, Winston-Salem, North Carolina 27157. (Email: slakoski{at}wfubmc.edu).
OBJECTIVES: The goal of this study was to determine the relationship between resting blood pressure (BP) and C-reactive protein (CRP) in a multi-ethnic cohort of men and women from the Multi-Ethnic Study of Atherosclerosis (MESA).
BACKGROUND: Several investigators have observed elevated levels of CRP in individuals with hypertension. Hypertension prevalence varies considerably across ethnic groups. Important questions remain regarding whether the relationship between hypertension and CRP is similar across ethnic and gender subgroups.
METHODS: The MESA participants had CRP levels determined at the baseline clinical examination (N = 6,814). Hypertension, treated as a dichotomous variable (yes/no), was defined as a systolic or diastolic BP  140/90 mm Hg or a self-reported history of hypertension and use of antihypertensive medications.
RESULTS: The geometric mean CRP in hypertensive participants was 2.3 ± 0.07 mg/l compared with 1.6 ± 0.07 mg/l among normotensive participants (p < 0.0001). The relative difference in CRP levels in hypertensives compared with normotensives was similar regardless of gender (13% in men and 13% in women). Ethnic comparisons showed that Chinese participants had the lowest CRP concentration but the largest difference in CRP by hypertension status (24%). Caucasians and African Americans had 10% to 15% higher CRP levels with hypertension, whereas Hispanics had no significant difference in CRP by hypertension status.
CONCLUSIONS: This study confirms the existence of an independent association between hypertension and inflammation in both men and women. Ethnic group differences were evident, with the strongest association observed in Chinese participants and no difference in CRP levels by hypertension status in Hispanics.
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Abbreviations and Acronyms
| | BP = blood pressure | | CRP = C-reactive protein | | HTN = hypertension | | JNC 7 = Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure | | MESA = Multi-Ethnic Study of Atherosclerosis | | MI = myocardial infarction |
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