C-reactive protein concentration and incident hypertension in young adults: the CARDIA study.
BACKGROUND
There is increasing evidence that C-reactive protein (CRP) concentration, a measure of inflammation, is an independent risk factor for the development of hypertension in older adults. However, it is unknown whether a similar relationship exists in younger individuals.


METHODS
The Coronary Artery Risk Development in Young Adults (CARDIA) study was initiated in 1985-1986 to determine the factors that are associated with coronary risk development in young adults. C-reactive protein concentrations were measured in 3919 African American and white men and women enrolled in CARDIA using blood specimens from the year 7 examination (1992-1993), when the age of the cohort was 25 to 37 years, and the year 15 examination (2000-2001).


RESULTS
In unadjusted analyses, CRP concentrations greater than 3 mg/L, compared with those less than 1 mg/L, was associated with a 79% greater risk of incident hypertension (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.40-2.28). However, CRP concentration did not predict risk of incident hypertension after adjusting for year 7 body mass index (BMI) (OR, 1.14; 95% CI, 0.86-1.53) or year 7 BMI and other potential confounders (OR, 1.13; 95% CI, 0.83-1.52). In addition, year 7 CRP concentration was not associated with change in systolic or diastolic blood pressure after adjusting for BMI (P = .10 and P = .70, respectively). These findings were similar within each of the race- and sex-specific groups.


CONCLUSIONS
C-reactive protein is associated with hypertension in young adults, but in contrast to the finding in older populations, the association is no longer present after adjusting for BMI.
Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA. slakoski@wfubmc.edu
Susan G
SG
Lakoski
David M
DM
Herrington
David M
DM
Siscovick
Stephen B
SB
Hulley
D000328:Adult; D044383:Black People; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000453:epidemiology*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American
D002097:C-Reactive Protein