title: High-sensitivity C-reactive protein is associated with the presence of coronary artery calcium in subjects with normal blood pressure but not in subjects with hypertension.
abstract: OBJECTIVE
  An association has been described between high sensitivity C-reactive protein (hs-CRP) and cardiovascular disease (CVD) in some studies but not in others. This finding may be explained by a differential impact of inflammation according to the absence or presence of certain co-existing risk factors. Because hypertension may be an effect modifier of inflammation on CVD, our aim was to investigate the relationship between hs-CRP and pre-clinical atherosclerosis in subjects with normal blood pressure and hypertension.
  
  
  METHODS
  Data were analyzed from 14,584 Korean subjects. Subjects were stratified according to: a) 6030 (41.3%) patients with normal blood pressure (<120/80 mmHg), b) 5630 (38.6%) patients with pre-hypertension (120-139 mmHg and 80-89 mmHg) and c) 2924 (20.0%) patients with hypertension (≥140/90 mmHg). Prevalence and odds ratio for the association between increased hs-CRP (>2 mg/L) and presence of CAC (coronary artery calcium) were calculated.
  
  
  RESULTS
  In both normal and pre-hypertensive groups, the prevalence of CAC >0 was higher in subjects with increased hs-CRP concentrations (>2 mg/L). Adjusting for age, sex, cerebrovascular accident, coronary heart disease and diabetes mellitus, lifestyle, obesity, fasting glucose, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol concentrations, there was a significant association between higher hs-CRP levels (>2 mg/L) and CAC score in the normal group (OR 1.55, 95% CI 1.11-2.16; p = 0.010); a borderline significant association in the pre-hypertensive group (OR 1.33, 95% CI 0.99-1.76; p = 0.054); and no association in the hypertensive group (OR 1.01, 95% CI 0.76-1.33; p = 0.94).
  
  
  CONCLUSIONS
  Higher hs-CRP levels (>2 mg/L) are associated with pre-clinical atherosclerosis in subjects with normal blood pressure but not hypertension.
authors: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors: Joo-Wook
authors: JW
authors: Sung
authors: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors: Sung Ho
authors: SH
authors: Lee
authors: Endocrinology and Metabolism Unit, IDS Building, Southampton General Hospital, (University of Southampton) and Southampton National Institute for Health Research Biomedical Research Centre, MP 887, Southampton, UK.
authors: Christopher D
authors: CD
authors: Byrne
authors: Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors: Pil-Wook
authors: PW
authors: Chung
authors: Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors: Yu Sam
authors: YS
authors: Won
authors: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: kcmd.sung@samsung.com.
authors: Ki-Chul
authors: KC
authors: Sung
mesh_terms: D050197:Atherosclerosis / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism*; D003331:Coronary Vessels / Q000378:metabolism*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D002118:Calcium
keywords: Coronary artery calcium; High-sensitivity C-reactive protein; Hypertension