title: Markers of inflammation are strong predictors of subclinical and clinical atherosclerosis in women with hypertension.
abstract: Cardiovascular diseases in women still rises and remains their leading cause of death in most developed countries; yet we have less sex-specific data in women than in men as a result of lower enrollment in clinical trials and low rates of sex-specific reporting. The aim of our study was to evaluate in hypertensive postmenopausal women the potential predictive role of markers of inflammation, for example, fibrinogen and C-reactive protein (CRP), on subclinical and clinical atherosclerosis, beyond that of the other established cardiovascular risk factors. We studied 127 asymptomatic hypertensive postmenopausal women with different degrees of carotid intima-media thickness, as examined by the eco-color-doppler ultrasonography, evaluating in a 5 years follow-up cerebrovascular and cardiovascular morbidity and mortality. We preliminarily found that both fibrinogen and CRP levels were associated with the extension of carotid atherosclerosis (P<0.0001 and P=0.0445, respectively). We also found that among all established traditional cardiovascular risk factors (including obesity, diabetes, smoking habit, family history of coronary artery disease, dyslipidemia) only older age (P=0.0162), elevated fibrinogen (P=0.0298), and CRP (P=0.0345) were independent predictors of subclinical atherosclerosis. At the end of follow-up patients clinical events were registered in the 24% of patients and multivariate analysis revealed the following predictors of events: elevated CRP levels [odds ratio (OR): 12.6], the presence of family history of coronary artery disease(OR: 8.8) and older age (OR: 1.1). Beyond the utility of CRP and fibrinogen levels in the prediction of subclinical and clinical atherosclerosis, the therapeutic implications of these results remain to be evaluated by further studies.
authors.affiliation: Department of Clinical Medicine and Emerging Diseases, University Hospital P. Giaccone, Palermo, Italy.
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.forename: Egle
authors.initials: E
authors.lastname: Corrado
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Coppola
authors.forename: Ida
authors.initials: I
authors.lastname: Muratori
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Novo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Novo
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D018836:Inflammation Mediators / Q000097:blood*; D008875:Middle Aged; D016017:Odds Ratio; D017698:Postmenopause; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color; D016387:Women's Health
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D005340:Fibrinogen; D002097:C-Reactive Protein