Blood pressure, C-reactive protein, and risk of future cardiovascular events
Blood pressure, C-reactive protein, and risk of future cardiovascular events
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DOI：
10.1161/01.cir.0000104566.10178.af
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发表时间：
2003-12-16
期刊：
影响因子：
37.8
通讯作者：
Ridker, PM
中科院分区：
文献类型：
--
作者：
Blake, GJ;Rifai, N;Ridker, PM
背景-积累的数据表明血压和血管inflammation.Methods和结果之间的联系-我们研究了血压，C-反应蛋白（CRP），和事件的第一次心血管事件之间的关系，在15 215名妇女前瞻性地随访了中位数为8.1年。在基线时的横断面分析中，血压< 120/75、120至129/75至84、130至139/85至89、140至159/90至94和>= 160/95 mm Hg的女性的CRP中位水平分别为0.96、1.42、2.20、2.82和3.34 mg/L，（P < 0.0001）。血压升高是基线CRP水平的重要预测因素。在前瞻性分析中，CRP水平升高（大于或等于3 mg/ L）和血压类别增加都是未来心血管事件的独立决定因素，并且CRP在所有血压水平下都具有增量预后价值。与血压<120/75和CRP水平< 3 mg/L的女性相比，血压≥ 160/95 mm Hg和CRP水平≥ 3 mg/L的女性的校正风险比为8.31（95% CI，4.44至15.55，P < 0.0001）。根据CRP水平将参与者分为4组后，（< 3或大于或等于3毫克/升）和血压水平（< 130/85或>= 130/85），危险因素校正的危险比如下：低CRP/低血压，1.0;高CRP/低血压，1.87低CRP/高血压为2.54（P <0.0001），高CRP/高血压为3.27（P < 0.0001）。
Background - Accumulating data suggest a link between blood pressure and vascular inflammation.Methods and Results - We examined the relationship between blood pressure, C-reactive protein (CRP), and incident first cardiovascular events among 15 215 women followed prospectively over a median of 8.1 years. In cross-sectional analyses at baseline, median levels of CRP for women with blood pressure < 120/75, 120 to 129/75 to 84, 130 to 139/85 to 89, 140 to 159/90 to 94, and >= 160/95 mm Hg were 0.96, 1.42, 2.20, 2.82, and 3.34 mg/L, respectively ( P for trend < 0.0001). Increasing categories of blood pressure were significant predictors of CRP levels at baseline. In prospective analyses, both elevated CRP levels ( greater than or equal to 3 mg/ L) and increasing categories of blood pressure were independent determinants of future cardiovascular events, and CRP had incremental prognostic value at all levels of blood pressure. The adjusted hazard ratio for women with blood pressure greater than or equal to 160/95 mm Hg and CRP levels greater than or equal to 3 mg/ L was 8.31 (95% CI, 4.44 to 15.55, P < 0.0001) compared with those with blood pressure < 120/75 and CRP levels < 3 mg/ L. After participants had been divided into 4 groups on the basis of CRP levels ( < 3 or greater than or equal to 3 mg/ L) and blood pressure levels ( < 130/85 or >= 130/85), the risk factor - adjusted hazard ratios were as follows: low CRP/low blood pressure, 1.0; high CRP/low blood pressure, 1.87 ( P = 0.002); low CRP/high blood pressure, 2.54 ( P < 0.0001); and high CRP/high blood pressure, 3.27 ( P < 0.0001).Conclusions - CRP and blood pressure are independent determinants of cardiovascular risk, and their predictive value is additive.