Prehypertension subtype with elevated C-reactive protein: risk of ischemic stroke in a general Japanese population.
BACKGROUND
Prehypertension (PreHT) and low-grade inflammation are both known to be related to the incidence of cardiovascular events. This cohort study investigated whether the high-risk group for future ischemic stroke among PreHT subjects can be predicted by stratification of high-sensitivity C-reactive protein (hsCRP).


METHODS
A total of 22,676 subjects aged 40-80 years from the general population who had no cardiovascular history underwent baseline measurement of serum hsCRP, and were followed for the incidence of ischemic stroke.


RESULTS
During the mean follow-up period of 2.7 years, 143 subjects had a first ischemic stroke. In a Cox multivariable model after adjustment for cardiovascular risk factors, there was no significant difference in hazard ratio (HR) for incidence of ischemic stroke between the normotension (NT) and PreHT subjects (HR = 1.72, 95% confidence interval (CI): 0.93-3.18, vs. NT subjects). In contrast, the HR for incidence of ischemic stroke in PreHT subjects with higher hsCRP levels (≥0.5 mg/l in men, ≥0.4 mg/l in women, more than median levels according to sex) was increased compared to NT subjects with lower hsCRP levels (HR = 2.63, 95% CI: 1.11-6.24). Moreover, the HR for incidence of ischemic stroke in PreHT subjects with lower CRP levels (HR = 0.91, 95% CI: 0.31-2.73) did not differ from that in NT subjects with lower hsCRP levels.


CONCLUSIONS
This study showed that, in a Japanese general population, hsCRP was a marker for relatively short-term risk of ischemic stroke in PreHT subjects.
Tanaka
Fumitaka
F
Department of Internal Medicine, Iwate Medical University, Morioka, Japan. xtc@rio.odn.ne.jp
Makita
Shinji
S
Onoda
Toshiyuki
T
Tanno
Kozo
K
Ohsawa
Masaki
M
Itai
Kazuyoshi
K
Sakata
Kiyomi
K
Onodera
Masayuki
M
Koeda
Yorihiko
Y
Kawarura
Kazuko
K
Terayama
Yasuo
Y
Yoshida
Yuki
Y
Ogawa
Akira
A
Okayama
Akira
A
Nakamura
Motoyuki
M
D000368:Aged; D044466:Asian People; D001794:Blood Pressure / Q000502:physiology; D002545:Brain Ischemia / Q000097:blood* / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000145:classification; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D020521:Stroke / Q000097:blood* / Q000453:epidemiology*
D002097:C-Reactive Protein