Increased C-reactive protein concentrations in never-treated hypertension

Schillaci, Giuseppe; Pirro, Matteo; Gemelli, F; Pasqualini, Leonella; Vaudo, Gaetano; Marchesi, Simona; Siepi, Donatella; Bagaglia, Francesco; Mannarino, Elmo

doi:10.1097/00004872-200310000-00010

Cited by 134 publications

(83 citation statements)

References 31 publications

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“…20 The other one may be related to inflammatory stimulation on vascular endothelium. Similar to the earlier investigations, 31,32 this study showed that the patients with hypertension had increased CRP, which is a marker for the presence of inflammation. Recently, we found that that CRP is able to induce EMP production in human umbilical vein endothelial cells (HUVECs).…”

Section: Discussionsupporting

confidence: 90%

Elevated circulating endothelial microparticles and brachial–ankle pulse wave velocity in well-controlled hypertensive patients

Wang

et al. 2008

J Hum Hypertens

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Vascular dysfunction in hypertensive condition is characterized by impaired endothelial function and reduced artery elasticity. Circulating endothelial microparticles (EMPs) and brachial-ankle pulse wave velocity (baPWV) are novel evaluation parameters for vascular function. However, their changes in patients with well-controlled blood pressure (BP) have not been fully acquired. To address this issue, circulating EMPs, defined as CD31 þ /CD42À MPs and baPWV were detected in 30 healthy subjects, 30 uncontrolled hypertensive (UCHT) patients and 23 well-controlled hypertensive (WCHT) patients. UCHT patients displayed elevated baPWV (Po0.01) and circulating EMPs (Po0.01) compared with healthy subjects. In WCHT patients, vascular damage represented by these two parameters constantly existed (Po0.01). Values of circulating EMPs were positively related to baPWV (Po0.01). Multivariate regression defined circulating EMPs as an independent contributor to the increase of baPWV value (Po0.05). Our study indicated that though BP was controlled, impaired endothelial function and arterial elasticity continued. The optimal therapy for patients with hypertension should include not only lowering BP but also improvement of vascular injury in parallel.

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Section: Discussionsupporting

confidence: 90%

Elevated circulating endothelial microparticles and brachial–ankle pulse wave velocity in well-controlled hypertensive patients

Wang

et al. 2008

J Hum Hypertens

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“…Our findings are in agreement with previous studies showing that higher levels of CRP are related to hypertension and pulse pressure [26,[30][31][32][33][34][35]. However, after lifecourse adjustments for confounders, the associations with pulse pressure and hypertension were markedly attenuated and no longer significant, suggesting that these associations are not causal.…”

Section: Discussionsupporting

confidence: 92%

Biomarkers of inflammation and endothelial dysfunction as predictors of pulse pressure and incident hypertension in type 1 diabetes: a 20 year life-course study in an inception cohort

et al. 2017

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Aims/hypothesis Vascular inflammation and endothelial dysfunction are thought to contribute to arterial stiffening and hypertension. This study aims to test this hypothesis with longitudinal data in the context of type 1 diabetes. Methods We investigated, in an inception cohort of 277 individuals with type 1 diabetes, the course, tracking and temporal inter-relationships of BP, specifically pulse pressure (a marker of arterial stiffening) and hypertension, and the following biomarkers of systemic and vascular inflammation/endothelial dysfunction: C-reactive protein (CRP), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cellular adhesion molecule-1 (sVCAM-1) and soluble E-selectin (sE-selectin). These biomarkers and other risk factors were measured at baseline and repeatedly up to 20 years after the onset of type 1 diabetes. Data were analysed with generalised estimating equations including adjustments for age, sex, smoking status, BMI, HbA 1c , serum creatinine, total cholesterol, urinary AER, insulin treatment dose and mean arterial pressure.Results Increases were noted in all biomarkers except sE-selectin, which decreased over time. Levels differed from baseline at 2-4 years and preceded the increase in pulse pressure, which occurred at 8-10 years after the onset of type 1 diabetes. Higher levels of sICAM-1 and sVCAM-1, but not CRP or sE-selectin, at baseline and throughout the 20 year follow-up, were significantly associated with higher (changes in) pulse pressure at subsequent time points. Higher levels of sVCAM-1 at baseline and during follow-up were also significantly associated with the prevalence (OR 3.60 of hypertension. We also investigated the longitudinal associations between BP or hypertension as determinants of subsequent (changes in) levels of CRP, sICAM-1, sVCAM-1 and sE-selectin, but did not find evidence to support a reverse causality hypothesis. Conclusions/interpretation These findings support the involvement of vascular endothelial dysfunction and inflammation in the development of premature arterial stiffening and hypertension in type 1 diabetes.

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“…The median hsCRP concentration that we found in the subjects without atherosclerosis, is close to that reported for never-treated hypertensive individuals (1.8 mg/l) by Schillaci et al 19 On the other hand, it is also similar to the average concentration in over 5000 apparently healthy Americans (1.6 mg/l). 17 Taken together, our findings suggest that elevated hsCRP concentrations should be attributed to atherosclerosis and not to hypertension by itself.…”

Section: Discussionsupporting

confidence: 89%

“…17,18 hsCRP is not only a predictor of overt cardiovascular disease, but it also has been associated with the presence and severity of subclinical systemic atherosclerosis as well as the presence of hypertension. 19,20 Previous angiographic studies have only visualized a limited part of the vascular tree, that is, carotid and coronary arteries. However, in patients suspected of having renovascular disease, both renal arteries and the abdominal aorta are visualized, thus allowing a relatively large part of the arterial system to be evaluated for atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

C-reactive protein, atherosclerosis and kidney function in hypertensive patients

et al. 2005

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Previous studies have shown a relationship between coronary or carotid atherosclerosis and C-reactive protein (CRP) concentrations. In the present investigation, we evaluated the relationship between high-sensitivity CRP (hsCRP) concentrations and the presence of atherosclerotic lesions in the renal arteries and/or abdominal aorta. In 95 hypertensive patients who underwent intraarterial DSA on suspicion of renovascular disease, blood was sampled during the procedure for measurement of hsCRP. The presence of atherosclerotic lesions was assessed at the level of the renal arteries and the abdominal aorta. Haemodynamically significant renal artery stenosis was diagnosed when 50% or more stenosis was observed. Patients with fibromuscular disease (n ¼ 8) or incomplete data (n ¼ 4) were excluded from analysis. The results revealed that the median hsCRP concentrations were significantly higher among the 57 patients with atherosclerosis of the aorta and/or renal arteries compared to those in the 26 patients without any angiographic lesions (4.6 vs 1.7 mg/l; Po0.005). Moreover, in patients with renal artery stenosis, levels of hsCRP were higher when the degree of stenosis exceeded 50%. However, the association between hsCRP and the presence of atherosclerosis appeared to be confounded by serum creatinine, creatinine clearance, age and gender. In the whole group a significant inverse relationship was found between creatinine clearance and hsCRP (Po0.05).In conclusion, hsCRP concentrations are related to atherosclerotic lesions in the renal arteries and the abdominal aorta. While this supports the view that atherosclerotic renal artery stenosis is part of a systemic inflammatory vascular disease, increased concentrations of CRP may also coincide with decreased renal function.

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Increased C-reactive protein concentrations in never-treated hypertension

Cited by 134 publications

References 31 publications

Elevated circulating endothelial microparticles and brachial–ankle pulse wave velocity in well-controlled hypertensive patients

Elevated circulating endothelial microparticles and brachial–ankle pulse wave velocity in well-controlled hypertensive patients

Biomarkers of inflammation and endothelial dysfunction as predictors of pulse pressure and incident hypertension in type 1 diabetes: a 20 year life-course study in an inception cohort

C-reactive protein, atherosclerosis and kidney function in hypertensive patients

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