Brewster Lizzy M, Mairuhu Gideon, Bindraban Navin R, Koopmans Richard P, Clark Joseph F, van Montfrans Gert A
Department of Internal Medicine, F4-222, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Circulation. 2006 Nov 7;114(19):2034-9. doi: 10.1161/CIRCULATIONAHA.105.584490. Epub 2006 Oct 30.
We previously hypothesized that high activity of creatine kinase, the central regulatory enzyme of energy metabolism, facilitates the development of high blood pressure. Creatine kinase rapidly provides adenosine triphosphate to highly energy-demanding processes, including cardiovascular contraction, and antagonizes nitric oxide-mediated functions. Relatively high activity of the enzyme, particularly in resistance arteries, is thought to enhance pressor responses and increase blood pressure. Tissue creatine kinase activity is reported to be high in black people, a population subgroup with greater hypertension risk; the proposed effects of high creatine kinase activity, however, are not "race dependent." We therefore assessed whether creatine kinase is associated with blood pressure in a multiethnic population.
We analyzed a stratified random sample of the population of Amsterdam, The Netherlands, consisting of 1444 citizens (503 white European, 292 South Asian, 580 black, and 69 of other ethnicity) aged 34 to 60 years. We used linear regression analysis to investigate the association between blood pressure and normal serum creatine kinase after rest, as a substitute measure of tissue activity. Creatine kinase was independently associated with blood pressure, with an increase in systolic and diastolic pressure, respectively, of 8.0 (95% CI, 3.3 to 12.7) and 4.7 (95% CI, 1.9 to 7.5) mm Hg per log creatine kinase increase after adjustment for age, sex, body mass index, and ethnicity.
Creatine kinase is associated with blood pressure. Further studies are needed to explore the nature of this association, including how variation in cardiovascular creatine kinase activity may affect pressor responses.
我们之前曾假设，能量代谢的核心调节酶肌酸激酶的高活性会促进高血压的发展。肌酸激酶能迅速为包括心血管收缩在内的高能量需求过程提供三磷酸腺苷，并拮抗一氧化氮介导的功能。该酶相对较高的活性，尤其是在阻力动脉中，被认为会增强升压反应并升高血压。据报道，黑人（高血压风险较高的人群亚组）的组织肌酸激酶活性较高；然而，肌酸激酶活性升高所产生的假定影响并非“种族依赖性”。因此，我们评估了在多民族人群中肌酸激酶是否与血压相关。
我们分析了荷兰阿姆斯特丹市人口的分层随机样本，该样本由1444名年龄在34至60岁之间的公民组成（503名欧洲白人、292名南亚人、580名黑人以及69名其他种族）。我们使用线性回归分析来研究静息后正常血清肌酸激酶与血压之间的关联，以此作为组织活性的替代指标。在对年龄、性别、体重指数和种族进行调整后，肌酸激酶与血压独立相关，每增加一个对数单位的肌酸激酶，收缩压和舒张压分别升高8.0（95%置信区间，3.3至12.7）和4.7（95%置信区间，1.9至7.5）毫米汞柱。
肌酸激酶与血压相关。需要进一步研究来探索这种关联的本质，包括心血管肌酸激酶活性的变化如何影响升压反应。
