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. 2009 Jul-Aug;3(4):260-6.
doi: 10.1016/j.jash.2009.03.003.

C-reactive Protein among Community-Dwelling Hypertensives on Single-agent Antihypertensive Treatment

Tibor Fulop  1 , Andrew D Rule, Darren W Schmidt, Heather J Wiste, Kent R Bailey, Iftikhar J Kullo, Gary L Schwartz, Thomas H Mosley, Eric Boerwinkle, Stephen T Turner
Affiliations

C-reactive Protein among Community-Dwelling Hypertensives on Single-agent Antihypertensive Treatment

Tibor Fulop et al. J Am Soc Hypertens. 2009 Jul-Aug.

Abstract

Background: C-reactive protein is a predictor of adverse cardiovascular outcomes. The effect of antihypertensive therapy on C-reactive protein levels is largely unknown.

Method: We undertook a cross-sectional study of CRP levels among participants with primary hypertension on single-agent anti-hypertensive therapy in the community-based biracial Genetic Epidemiology Network of Arteriopathy cohort. Linear regression models were used to assess the association of anti-hypertensive medication class with log-transformed C-reactive protein after adjustment for age, gender, ethnicity, body mass index, smoking, diabetes, HMG-Co-A reductase inhibitor use, achieved blood pressure control (<140/90 mmHg), serum creatinine and urine albumin-to-creatinine ratios.

Results: There were 662 participants in the cohort taking single-agent therapy for hypertension. Median C-reactive protein levels differed across participants: 0.40 mg/dL for those on diuretics, 0.34 mg/dL on calcium channel blockers, 0.25 mg/dL on beta blockers and 0.27 mg/dL on renin-angiotensin-aldosterone system inhibitors (p<0.001). With multivariable adjustment, the group on renin-angiotensin-aldosterone system inhibitors had a 20% lower mean CRP on average than the group on diuretics (p=0.044), differences between other medication classes were not apparent. Heart rate had a strong association with C-reactive protein (p < 0.001).

Conclusions: Antihypertensive medication class may influence inflammation, particularly in patients on RAAS inhibitors.

Keywords: C-reactive protein; RAAS inhibitors; antihypertensive therapy; diuretics; inflammation; sibships.

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