C-Reactive Protein Is Associated With Arterial Stiffness in Apparently Healthy Individuals

Abstract

Objective-C-reactive protein (CRP) levels predict outcome in healthy individuals and patients with atherosclerosis.Arterial stiffness also independently predicts all-cause and cardiovascular mortality and may be involved in the process of atherosclerosis. The aim of this study was to investigate the relationship between stiffness and inflammation in a cohort of healthy individuals. Methods and Results-Pulse wave velocity (PWV) and blood pressure were assessed in 427 individuals. Subjects with cardiovascular disease, diabetes, hypercholesterolemia and those using medication were excluded. CRP correlated with age, mean arterial pressure (MAP), brachial and aortic PWV, and pulse pressures. In multiple regression models, aortic PWV correlated independently with age, CRP, male gender, and MAP (R 2 ϭ0.593; PϽ0.001). CRP was also independently associated with brachial PWV. Aortic augmentation index correlated with age, gender, MAP, and inversely with heart rate and height, but not with CRP (R 2 ϭ0.794; PϽ0.001). Aortic, carotid, and brachial pulse pressures were also independently associated with CRP levels. Conclusion-Aortic and brachial PWV, and pulse pressure, relate to levels of inflammation in healthy individuals, suggesting that inflammation may be involved in arterial stiffening. Anti-inflammatory strategies may, therefore, be of benefit in reducing arterial stiffness and thus cardiovascular risk, especially in patients with premature arterial stiffening. Key Words: C-reactive protein Ⅲ pulse wave analysis Ⅲ augmentation index Ⅲ pulse wave velocity Ⅲ inflammation T he pathogenesis of atherosclerosis remains incompletely understood, but inflammation is thought to play an important role. 1 Several studies have demonstrated that serum levels of the acute phase protein, C-reactive protein (CRP), independently predict outcome in patients with cardiovascular disease 2,3 and in apparently healthy individuals. 4,5 Levels of CRP also correlate with endothelial function, an independent predictor of cardiovascular risk, 6 in patients with coronary artery disease. 7 Moreover, CRP has direct proinflammatory effects on human endothelial cells in vitro 8 and can induce endothelial dysfunction. 9 Aortic pulse wave velocity (PWV), a measure of aortic distensibility, predicts mortality in patients with end-stage renal failure, hypertension, diabetes, and older otherwise healthy individuals, independently of known confounding factors. 10 -13 Interestingly, recent evidence suggests that brachial pulse pressure, a surrogate measure of arterial stiffness, is correlated with CRP and interleukin-6 (IL-6) levels in apparently healthy men. 14,15 Moreover, an association between CRP and aortic PWV has been reported in subjects with end-stage renal failure. 16 However, whether there is any relationship between inflammation and central pulse pressure or more direct indices of arterial stiffness such as aortic PWV in healthy individuals is unclear. We hypothesized that CRP levels would be correlated with aortic PWV and central pulse pressure...

The association between aortic augmentation index and cardiovascular risk factors in a large unselected population

“…32 Most studies have reported an association between arterial stiffness measured by AIx 33,34 and high levels of markers of inflammation including hs-CRP, although some only found hs-CRP to be associated with PWV. 35 Current smoking was associated with at higher AIx in young women compared with young men and also with a faster attenuation of this relationship with increasing age in women compared with men. Smoking has rather consistently been associated with increased AIx.…”

Endothelial Dysfunction and Low-Grade Inflammation Are Associated With Greater Arterial Stiffness Over a 6-Year Period

“…10 -26 On aggregate, previous studies have shown higher CRP levels to be associated with greater arterial stiffness of elastic, 10 -14,16 -23 muscular, 25 or both types of arteries 26 and higher interleukin 6 levels to be associated with greater elastic arterial stiffness. 11,15 Taken together, these studies 10 -23,25,26 and the present results support the concept that low-grade inflammation may affect arterial stiffness.…”

Arterial Stiffness is Associated with Tissue Doppler Atrial Conduction Times and P Wave Dispersion in Hypertensive Patients

“…Other potential mechanisms include the possibility that increased arterial stiffness predisposes to neurohormonal activation (25) or a generalized cardiovascular inflammatory response (26), which, in turn may contribute to the development of AF (27). The study illustrates the importance of considering target organ damage at the sub-clinical stage in the hypertensive patient and reopens the question of a potential benefit of anti-hypertensive agents beyond reduction in arterial blood pressure (28).…”