title: Creatine kinase is associated with failure of hypertension treatment.
abstract: BACKGROUND
  Failure of hypertension treatment is a major clinical issue because of the high prevalence and the associated mortality risk. We have reported evidence that creatine kinase increases blood pressure through greater sodium retention and cardiovascular contractility, by rapidly providing ATP for these functions. Therefore, we hypothesized that high creatine kinase is associated with failure of antihypertensive treatment.
  
  
  METHODS
  We analyzed a cross-sectional, random multiethnic sample of the general population (N = 1444), aged 34-60 years. The primary outcome was the independent association between resting serum creatine kinase and treated uncontrolled hypertension in the population, using multinomial logistic regression analysis.
  
  
  RESULTS
  Hypertension prevalence was, respectively, 26.8; 30.8; and 41.2% for the lowest (<88  IU/l) through the highest population creatine kinase tertile (>145  IU/l; P < 0.001). Treatment failed in 72.9% of participants within the highest creatine kinase tertile vs. 46.7% within the lowest tertile (P = 0.004). In logistic regression analysis, creatine kinase was the main predictor of treatment failure (adjusted odds ratio 3.7; 95% confidence interval 1.2-10.9), independent of age, sex, BMI, fasting glucose, ethnicity, or education level.
  
  
  CONCLUSIONS
  Creatine kinase is associated with failure of antihypertensive therapy. Further investigations concerning this association might help improve treatment strategies for difficult-to-treat hypertension.
authors: Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors: Inge
authors: I
authors: Oudman
authors: Preschana V
authors: PV
authors: Kewalbansingh
authors: Irene
authors: I
authors: van Valkengoed
authors: Aeilko H
authors: AH
authors: Zwinderman
authors: Joseph F
authors: JF
authors: Clark
authors: Gert A
authors: GA
authors: van Montfrans
authors: Lizzy M
authors: LM
authors: Brewster
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003402:Creatine Kinase / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000201:enzymology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure
chemical_list: D000959:Antihypertensive Agents; D003402:Creatine Kinase