January 1, 2020Journal of Primary Care & Community HealthOpen Access

Association of Elevated Levels of Inflammatory Marker High-Sensitivity C-Reactive Protein and Hypertension

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Why the study?

Hypertension is described as an inflammatory vascular disease, prompting evaluation of the association between elevated hs-CRP levels, hypertension, and other comorbid conditions.

Does elevated hs-CRP associate with increased prevalence of hypertension in adult internal medicine patients?

Structured PICO

Does elevated hs-CRP associate with increased prevalence of hypertension in adult internal medicine patients?

Population

169 adult patients in an internal medicine office

Intervention

Elevated high sensitivity-CRP (hs-CRP ≥2 mg/L)

Comparator

Normal hs-CRP (<2 mg/L)

Outcome

Prevalence of hypertension

In this outpatient cohort, there was no statistically significant correlation between elevated hs-CRP levels and hypertension, though significant associations were found with white blood cell count, alcohol use, and HDL levels.

Implication

hs-CRP elevation was associated with hypertension; hypothesis-generating and requires validation before clinical use.

Abstract

Introduction The correlation between inflammation and vascular disease is widely accepted. High levels of C-reactive protein (CRP) have been shown to play a role in the process of endothelial dysfunction. Hypertension is described as an inflammatory vascular disease, and is 1 of the most commonly encountered diseases in the outpatient setting. We studied the association between the elevated high sensitivity-CRP (hs-CRP) level and hypertension, as well as other comorbid conditions. Methods Electronic medical records of 169 adult patients in our internal medicine office were reviewed for hs-CRP levels, and divided into 2 groups: elevated hs-CRP (≥2 mg/L; n = 110) and normal hs-CRP (<2 mg/L; n = 59). Independent T-Test was used to compare the means of continuous variables between the groups if they were normally distributed. Mann Whitney U-Test was used to compare the continuous variables that were non-parametric. Logistic regression was used to compare the dependent and independent variables. Results Among subjects with elevated hs-CRP, 58.2% had hypertension while 47.5% of subjects with normal hs-CRP levels had hypertension ( P = .182). There were higher frequencies of association of coronary artery disease (CAD), cerebrovascular disease and hypothyroidism in elevated hs-CRP group but the differences were not statistically significant. Mean white blood cell count was statistically higher in elevated hs-CRP group ( P < .05), while alcohol use was significantly higher ( P < .05) and statin use was higher in the normal hs-CRP group. There was an inverse relationship between HDL-C and hs-CRP. Conclusions There was no statistically significant correlation between hs-CRP level and hypertension. Hs-CRP has statistically significant associations between alcohol use, dementia, white blood cell count, and HDL levels. Promising but not statistically significant correlations were observed between hs-CRP and statin therapy, hypothyroidism, coronary artery disease, and cerebrovascular disease.