Antihypertensive medications and C-reactive protein in the multi-ethnic study of atherosclerosis.
BACKGROUND
The effects of different antihypertensive medication classes on C-reactive protein (CRP) levels are still not well characterized, and might be of relevance to treatment choices.


METHODS
We studied the association between antihypertensive medication class and CRP levels among participants with treated hypertension in the Multi-Ethnic Study of Atherosclerosis. We performed a cross-sectional study of hypertensive participants free of clinical cardiovascular disease who were taking one or more of the following medication classes: beta-blockers, calcium channel blockers, diuretics, and angiotensin-converting enzyme (ACE) inhibitors, or angiotensin II type I receptor blockers (ARB).


RESULTS
Among 2340 participants taking one or more antihypertensive medications, the mean serum CRP level was lower among participants taking a beta-blocker than among those not taking a beta-blocker (2.13 v 2.54 mg/L, P = .002). This difference persisted after multivariate adjustment (P = .021). There were no other statistically significant differences in multivariate models. Among 1314 participants receiving monotherapy, the multivariate adjusted mean CRP level among participants taking a beta-blocker was lower (1.97 mg/L) than those taking a diuretic (2.72 mg/L, P < .001). In this monotherapy group, participants taking an ACE inhibitor or ARB also had a lower adjusted mean CRP (2.25 mg/L) than those taking a diuretic (P = .046). African-American race/ethnicity did not modify any of those relationships.


CONCLUSIONS
The beta-blocker use was associated with lower CRP levels overall and among participants on monotherapy, whereas ACE inhibitor and ARB use was associated with lower CRP levels among participants on monotherapy. These findings warrant further evaluation in randomized trials.
Palmas
Walter
W
Division of General Medicine, Department of Medicine, Mailman School of Public Health, Columbia University Medical Center, New York, New York.
Ma
Shuangge
S
Psaty
Bruce
B
Goff
David C
DC
Darwin
Christine
C
Barr
R Graham
RG
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000208:ethnology / Q000209:etiology*; D002097:C-Reactive Protein / Q000378:metabolism*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D014481:United States
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D002097:C-Reactive Protein