title: Relation of C-reactive protein, fibrinogen, and cardiorespiratory fitness to risk of systemic hypertension in men.
abstract: We investigated the relation between inflammation and incident hypertension, independent of obesity, and tested the associations of cardiorespiratory fitness (fitness) and indexes of inflammation for the development of hypertension in 2,475 normotensive men. Inflammatory markers were C-reactive protein (CRP) and fibrinogen. Fitness was directly measured by peak oxygen uptake during sign/symptom-limited treadmill exercise testing to volitional fatigue; 266 men (10.7%) developed hypertension during an average of 4 years follow-up. After adjusting for potential confounding variables, the relative risk (RR) and 95% confidence interval (CI) for incident hypertension in those in the upper tertile versus lower tertile were 1.55 (95% CI 1.15 to 2.09) for CRP and 1.51 (95% CI 1.10 to 2.06) for fibrinogen. Although the association between fibrinogen and incident hypertension persisted after adjusting for body mass index (p = 0.049), the relation between CRP and incident hypertension was no longer statistically significant (p = 0.08). Fit men had a 27% decreased (RR 0.73, 95% CI 0.56 to 0.94) risk of incident hypertension compared with unfit men in a multivariable adjusted model. In the joint analysis, unfit men with upper CRP had 1.81 times (95% CI 1.21 to 2.70) and unfit men with upper fibrinogen had 2.03 times (95% CI 1.33 to 3.12) greater risks of incident hypertension compared with fit men with low CRP and fibrinogen, respectively. However, these risks did not significantly increase in fit men with upper CRP (RR 1.12, 95% CI 0.76 to 1.63) and fibrinogen (RR 1.26, 95% CI 0.86 to 1.85) groups. In conclusion, these results suggest that heightened levels of fibrinogen, but not CRP, are associated with incident hypertension, independent of body weight, and that high fitness attenuates the risk of incident hypertension across upper levels of inflammatory markers in men.
authors.affiliation: Department of Sport Science, University of Seoul, Seoul, South Korea; Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois. Electronic address: syjae@uos.ac.kr.
authors.forename: Sae Young
authors.initials: SY
authors.lastname: Jae
authors.affiliation: Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Sudhir
authors.initials: S
authors.lastname: Kurl
authors.affiliation: Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Jari A
authors.initials: JA
authors.lastname: Laukkanen
authors.affiliation: Exercise and wellness program, Arizona State University, Phoenix, Arizona.
authors.forename: Chong-Do
authors.initials: CD
authors.lastname: Lee
authors.affiliation: Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Yoon-Ho
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Bo
authors.initials: B
authors.lastname: Fernhall
authors.affiliation: Preventive Cardiology and Cardiac Rehabilitation, Deparment of Cardiovascular Disease, William Beaumont Hospital, Royal Oak, Michigan.
authors.forename: Barry A
authors.initials: BA
authors.lastname: Franklin
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology*; D015994:Incidence; D007249:Inflammation / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D056910:Republic of Korea; D012306:Risk
chemical_list: D015415:Biomarkers; D005340:Fibrinogen; D002097:C-Reactive Protein