Department of Cardiology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
Department of General Practice, Jinyang Community Health Service Center, Shanghai, 200136, China.
BMC Cardiovasc Disord. 2023 Sep 27;23(1):480. doi: 10.1186/s12872-023-03509-z.
The aim of this study was to investigate the relationship between Hypersensitive C-reactive protein (hs-CRP) and left ventricular hypertrophy (LVH) in elderly community-dwelling patients with hypertension.
A cross-sectional study was conducted, involving the recruitment of 365 elderly hypertensive residents ≥ 65 years of age from five communities. The participants were divided into two groups: an LVH group (n = 134) and a non-LVH group (n = 231), based on the left ventricular mass index (LVMI) determined by echocardiography. Spearman correlation analysis was used to assess the relationship between hs-CRP and LVH. Univariate and Multivariate analysis was performed to detect variables associated with LVH. The diagnostic value of hs-CRP for LVH was expressed as the area under the receiver operating characteristic (ROC) curve.
The incidence of LVH in elderly hypertension patients in the community was 36.7%. The hs-CRP levels were significantly higher in subjects with LVH compared to those without LVH (1.9 [0.8, 2.9] vs. 0.7 [0.4, 1.4], P = 0.002). Spearman correlation analysis demonstrated a positive correlation between hs-CRP and LVMI (r = 0.246, P < 0.001), as well as with IVST (r = 0.225, P < 0.001) and LVPWT (r = 0.172, P = 0.001). Among elderly hypertensive residents in the community, the cut-off value of hs-CRP for diagnosing LVH was 1.25 mg/L (sensitivity: 57.5%; specificity: 78.4%), and the area under the ROC curve for hs-CRP to predict LVH was 0.710 (95%CI: 0.654-0.766; P < 0.001). In the final model, hs-CRP ≥ 1.25 mg/L (OR = 3.569; 95%CI, 2.153-5.916; P<0.001) emerged as an independent risk factor for LVH. This association remained significant even after adjusting for various confounding factors (adjusted OR = 3.964; 95%CI, 2.323-6.765; P < 0.001).
This community-based cohort of elderly hypertensive individuals demonstrates a strong association between hs-CRP levels and the presence of LVH. The hs-CRP ≥ 1.25 mg/L may serve as an independent predictor for LVH in hypertensive subjects and exhibit good diagnostic efficacy for LVH.
本研究旨在探讨社区老年高血压患者超敏 C 反应蛋白（hs-CRP）与左心室肥厚（LVH）之间的关系。
采用横断面研究方法，从五个社区招募了 365 名年龄≥65 岁的老年高血压居民。根据超声心动图确定的左心室质量指数（LVMI），将参与者分为 LVH 组（n=134）和非 LVH 组（n=231）。采用 Spearman 相关分析评估 hs-CRP 与 LVH 的关系。采用单因素和多因素分析检测与 LVH 相关的变量。hs-CRP 对 LVH 的诊断价值用受试者工作特征（ROC）曲线下面积表示。
社区老年高血压患者 LVH 的发生率为 36.7%。与无 LVH 者相比，LVH 者 hs-CRP 水平明显升高（1.9[0.8, 2.9] vs. 0.7[0.4, 1.4]，P=0.002）。Spearman 相关分析显示，hs-CRP 与 LVMI 呈正相关（r=0.246，P<0.001），与 IVST（r=0.225，P<0.001）和 LVPWT（r=0.172，P=0.001）也呈正相关。在社区老年高血压居民中，hs-CRP 诊断 LVH 的截断值为 1.25mg/L（敏感性：57.5%；特异性：78.4%），hs-CRP 预测 LVH 的 ROC 曲线下面积为 0.710（95%CI：0.654-0.766；P<0.001）。在最终模型中，hs-CRP≥1.25mg/L（OR=3.569；95%CI，2.153-5.916；P<0.001）是 LVH 的独立危险因素。即使在调整了各种混杂因素后，这种关联仍然显著（调整后的 OR=3.964；95%CI，2.323-6.765；P<0.001）。
本社区老年高血压人群中，hs-CRP 水平与 LVH 之间存在较强的相关性。hs-CRP≥1.25mg/L 可能是高血压患者 LVH 的独立预测因子，对 LVH 具有良好的诊断效能。
