High-sensitivity C-reactive protein is independently associated with early carotid artery progression in women but not in men - The INVADE study

Background and Purpose - High-sensitivity C-reactive protein (hsCRP) is known to be associated with atherosclerosis and cardiovascular events. Limited information exists regarding the importance of sex differences for the association between hsCRP and the progression of early stages of atherosclerosis. Therefore, we investigated the effect of hsCRP on early carotid atherosclerosis progression and major vascular risk factors in men and women. Methods - We analyzed the data of INVADE (intervention project on cerebrovascular diseases and dementia in the community of Ebersberg, Bavaria), a prospective, population-based study. In addition to common risk factors, measurements of carotid intima-media-thickness and hsCRP were performed at baseline and after 2 years. Results - Complete baseline data were available for 3387 subjects including 2001 women, and complete follow-up data were available for 2346 subjects. Within this study population, women were older and had higher systolic blood pressure and cholesterol levels. The prevalence of smoking and ischemic heart disease was more frequent in men. The baseline carotid intima-media-thickness was significantly higher in men compared with women (0.82 mm; 95% CI, 0.812 to 0.834 mm versus 0.77 mm; 95% CI, 0.763 to 0.779 mm; P < 0.0001). Carotid intima-media-thickness progression after risk factor adjustment was significantly associated with hsCRP in women (P = 0.006) but not in men (P = 0.39). Conclusions - The association between hsCRP and progression of early carotid atherosclerosis shows sex differences. In further studies analyzing the role of inflammation for cardiovascular diseases and atherosclerosis, these sex differences should be considered.