High-sensitivity C-reactive Protein Is Associated with the Presence of Coronary Artery Calcium in Subjects with Normal Blood Pressure but Not in Subjects with Hypertension

Background and Aims. An association has been described between high sensitivity C-reactive protein (hs-CRP) and cardiovascular disease (CVD) in some studies but not in others. This finding may be explained by a differential impact of inflammation according to the absence or presence of certain co-existing risk factors. Because hypertension may be an effect modifier of inflammation on CVD, our aim was to investigate the relationship between hs-CRP and pre-clinical atherosclerosis in subjects with normal blood pressure and hypertension. Methods. Data were analyzed from 14,584 Korean subjects. Subjects were stratified according to: a) 6030 (41.3%) patients with normal blood pressure (<120/80 mmHg), b) 5630 (38.6%) patients with pre-hypertension (120-139 mmHg and 80-89 mmHg) and c) 2924 (20.0%) patients with hypertension (>= 140/90 mmHg). Prevalence and odds ratio for the association between increased hs-CRP (> 2 mg/L) and presence of CAC (coronary artery calcium) were calculated. Results. In both normal and pre-hypertensive groups, the prevalence of CAC >0 was higher in subjects with increased hs-CRP concentrations (> 2 mg/L). Adjusting for age, sex, cerebrovascular accident, coronary heart disease and diabetes mellitus, lifestyle, obesity, fasting glucose, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol concentrations, there was a significant association between higher hs-CRP levels (>2 mg/L) and CAC score in the normal group (OR 1.55, 95% CI 1.11-2.16; p = 0.010); a borderline significant association in the pre-hypertensive group (OR 1.33, 95% CI 0.99-1.76; p = 0.054); and no association in the hypertensive group (OR 1.01, 95% CI 0.76-1.33; p = 0.94). Conclusions. Higher hs-CRP levels (>2 mg/L) are associated with pre-clinical atherosclerosis in subjects with normal blood pressure but not hypertension. (C) 2014 IMSS. Published by Elsevier Inc.