Fulop Tibor, Rule Andrew D, Schmidt Darren W, Wiste Heather J, Bailey Kent R, Kullo Iftikhar J, Schwartz Gary L, Mosley Thomas H, Boerwinkle Eric, Turner Stephen T
Internal Medicine, University of Mississippi Medical Center, Jackson, MS, United States.
J Am Soc Hypertens. 2009 Jul-Aug;3(4):260-6. doi: 10.1016/j.jash.2009.03.003.
C-reactive protein is a predictor of adverse cardiovascular outcomes. The effect of antihypertensive therapy on C-reactive protein levels is largely unknown.
We undertook a cross-sectional study of CRP levels among participants with primary hypertension on single-agent anti-hypertensive therapy in the community-based biracial Genetic Epidemiology Network of Arteriopathy cohort. Linear regression models were used to assess the association of anti-hypertensive medication class with log-transformed C-reactive protein after adjustment for age, gender, ethnicity, body mass index, smoking, diabetes, HMG-Co-A reductase inhibitor use, achieved blood pressure control (<140/90 mmHg), serum creatinine and urine albumin-to-creatinine ratios.
There were 662 participants in the cohort taking single-agent therapy for hypertension. Median C-reactive protein levels differed across participants: 0.40 mg/dL for those on diuretics, 0.34 mg/dL on calcium channel blockers, 0.25 mg/dL on beta blockers and 0.27 mg/dL on renin-angiotensin-aldosterone system inhibitors (p<0.001). With multivariable adjustment, the group on renin-angiotensin-aldosterone system inhibitors had a 20% lower mean CRP on average than the group on diuretics (p=0.044), differences between other medication classes were not apparent. Heart rate had a strong association with C-reactive protein (p < 0.001).
Antihypertensive medication class may influence inflammation, particularly in patients on RAAS inhibitors.
C反应蛋白是心血管不良结局的一个预测指标。抗高血压治疗对C反应蛋白水平的影响在很大程度上尚不清楚。
我们在基于社区的双种族动脉病遗传流行病学网络队列中，对接受单药抗高血压治疗的原发性高血压参与者的C反应蛋白水平进行了一项横断面研究。在调整年龄、性别、种族、体重指数、吸烟、糖尿病、HMG-Co-A还原酶抑制剂使用情况、血压控制达标（<140/90 mmHg）、血清肌酐和尿白蛋白与肌酐比值后，使用线性回归模型评估抗高血压药物类别与对数转换后的C反应蛋白之间的关联。
该队列中有662名参与者接受高血压单药治疗。不同参与者的C反应蛋白水平中位数不同：利尿剂使用者为0.40 mg/dL，钙通道阻滞剂使用者为0.34 mg/dL，β受体阻滞剂使用者为0.25 mg/dL，肾素-血管紧张素-醛固酮系统抑制剂使用者为0.27 mg/dL（p<0.001）。经过多变量调整后，肾素-血管紧张素-醛固酮系统抑制剂组的平均C反应蛋白水平平均比利尿剂组低20%（p=0.044），其他药物类别之间的差异不明显。心率与C反应蛋白有很强的关联（p < 0.001）。
抗高血压药物类别可能影响炎症，特别是在使用肾素-血管紧张素-醛固酮系统抑制剂的患者中。
