Clinical Significance of High-Sensitivity C-Reactive Protein in Hypertensive Patients Detected by Health-Check Program

Cha, Young Joo; Hong, Hae Rim; Chae, Seok Lae; Park, Ae Ja

Abstract

BACKGROUND
C-reactive protein (CRP) levels are known to reflect chronic inflammatory processes of the cardiovascular system. In particular, it has been reported that high-sensitivity CRP (hs-CRP) may be a promising marker of development of atherosclerosis and cardiovascular disease. CRP may also have an active role in atherogenesis. METHODS: The relationship between hs-CRP and the classic cardiovascular risk factors was assessed in 186 subjects, aged 23-75 years, who entered the health-check program of Chung-Ang University Hospital. hs-CRP was measured by immunoturbidimetric assay. Quintiles of hs-CRP (quintile 1; < 0.7, quintile 2; 0.7-1.1, quintile 3; 1.2-1.9, quintile 4; 2.0-3.8, quintile 5; 3.9-15 mg/L), total cholesterol (TC)/high density lipoprotien-cholesterol (HDL-C) ratio, and relative risk (RR) estimates derived from quintiles of hs-CRP and TC/ HDL-C ratio, were used for the data analysis. RESULTS: Of the 186 subjects, 48 were hypertensive and 138 were normotensive. The serum hs-CPR values for the hypertensive subjects were 0.27+/-0.83 mg/L, compared to 0.12+/-0.23 mg/L for the normotensive subjects; this difference was not significant (P=0.0536) when tested on the arithmetic means, but highly significant (P=0.0091) when the geometric means were compared. The quitiles of hs-CRP were also significantly higher (P=0.0094) in the hypertensive subjects than in the normotensive subjects, when evaluated using Wilcoxon rank sum test. Of the 138 normotensive subjects, only 35 (25.4%) were in quintile 3 or over 3 and 18 (13.0%) in quintile 4 or 5, whereas the respective figures for the 48 hypertensive subjects were 21 (43.8%) and 15 (31.3%). Similarly, of the normotensive subjects, only 47 (34.1%) had RR estimates over 2 and 19 (13.8%) over 3, whereas the respective figures for the hypertentive subjects were 28 (58.3%) and 16 (33.3%). CONCLUSIONS: High-sensivity CRP may be useful in for the screening of the subjects who need preventive measures against cardiovascular diseases. The quintiles of hs-CRP, together with TC/HDL-C ratio, may be useful for the estimation of RR in subjects with low levels of hs-CRP.