C-reactive protein is not related to ambulatory blood pressure or target organ damage in treated hypertensives

Background: Publication of the JUPITER trial has renewed the interest in the use of CRP in cardiovascular risk prediction. The aim of the study was to assess the relationship between CRP, ambulatory blood pressure and target organ damage in a cohort of treated hypertensive males without overt cardiovascular disease. Materials and methods: The studied group consisted of 299 male hypertensive patients. Patients were stratified into low (≤ 2 mg/L), intermediate (2-5 mg/L), and high (> 5 mg/L) CRP groups. We measured ambulatory blood pressure, pulse wave velocity, left ventricular function and structure, carotid intima media thickness and ankle-brachial index. Results: Twenty-six percent of the patients had CRP in the range of 2 to 5 mg/L, and 12% had CRP levels exceeding 5 mg/L. Ambulatory blood pressure and heart rate were not different across the three groups. Patients with high CRP had lower HDL cholesterol levels and higher plasma fibrinogen levels. Carotid femoral pulse wave velocity, carotid intima media thickness and ankle-brachial index were not different across the three groups. Echocardiographic data were also not related to the CRP level. Conclusions: 1. Elevated levels of CRP are frequently observed among treated patients with hypertension. 2. CRP elevation is associated with higher fibrinogen and glucose levels, and lower HDL cholesterol independently of obesity and smoking status. 3. Elevated CRP levels are not related to ambulatory blood pressure profile or target organ damage severity. 4. Our findings are consistent with the concept that CRP measurement is of limited value in cardiovascular assessment.