Relationship between C-reactive protein and progression of early carotid atherosclerosis in hypertensive subjects

Background and Purpose - Hypertensive outpatients were investigated for C-reactive protein (CRP) and carotid atherosclerosis because the influence of CRP on the progression of subclinical atherosclerosis in hypertensives remains unclear. Methods - A total of 124 outpatients ( aged 40 to 79 years) in treatment for hypertension were enrolled. They underwent repeated ultrasonographic evaluation of the carotid arteries for 35 +/- 12 months. Focal intima-media thickening of greater than or equal to 1.1 mm was defined as plaque, and the plaque number, plaque score, and the sum of all plaque thickness were calculated. Results - Multivariate linear regression analysis revealed that CRP, pulse pressure, and systolic blood pressure were related to the annual change of plaque number ( beta = 0.34, 0.27, and 0.30; all P < 0.01) and plaque score ( beta = 0.38, 0.27, and 0.23; P < 0.001, P < 0.01, and P < 0.05, respectively) independently of other risk factors. In 64 patients taking antihypertensive medications with a blood pressure of < 140/90 mm Hg, CRP and the pulse pressure were related to the annual change of plaque number ( r = 0.40 and 0.26; P < 0.01 and P < 0.05, respectively) and plaque score ( r = 0.44 and 0.31; P < 0.001 and P < 0.05, respectively). Conclusions - In hypertensive patients being managed by drug therapy or lifestyle modification, CRP is an equivalent or superior independent predictor of the progression of carotid atherosclerosis than the pulse pressure or systolic blood pressure.