C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey

Objective. To explore the association between high sensitivity C-reactive protein (hs-CRP) levels and incident hypertension, as well as the association between hs-CRP levels and related covariates, in a Chinese adult population. Methods. This study was based on the China Health and Nutrition Survey,...

Full description

Saved in:
Bibliographic Details
Main Authors: Bo Chen, Yuze Cui, Mengyun Lei, Wenlei Xu, Qiongjie Yan, Xiaotong Zhang, Minghui Qin, Shaoyong Xu
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:International Journal of Hypertension
Online Access:http://dx.doi.org/10.1155/2021/3326349
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849683314443550720
author Bo Chen
Yuze Cui
Mengyun Lei
Wenlei Xu
Qiongjie Yan
Xiaotong Zhang
Minghui Qin
Shaoyong Xu
author_facet Bo Chen
Yuze Cui
Mengyun Lei
Wenlei Xu
Qiongjie Yan
Xiaotong Zhang
Minghui Qin
Shaoyong Xu
author_sort Bo Chen
collection DOAJ
description Objective. To explore the association between high sensitivity C-reactive protein (hs-CRP) levels and incident hypertension, as well as the association between hs-CRP levels and related covariates, in a Chinese adult population. Methods. This study was based on the China Health and Nutrition Survey, a continuing open, large-scale prospective cohort study. Adult participants who were free of hypertension were included at baseline survey in 2009 and were followed up in 2015 (follow-up rate: 77.45%). The hs-CRP was measured using the immunoturbidimetric method and divided into three groups: low-risk group (0 ≤ hs-CRP <1 mg/L), average-risk group (1 ≤ hs-CRP <3 mg/L), and high-risk group (3 ≤ hs-CRP ≤10 mg/L). Definite diagnosis of hypertension in the follow-up survey in 2015 was the endpoint event of this study. The areas under the curve (AUC) of the receiver operating characteristic (ROC) curve analyses were used to evaluate the predictive value of the hs-CRP. Results. 3794 participants were finally included as study sample, of whom 912 developed hypertension during a 6-year follow-up period (incidence: 24.1%). The incidences of hypertension in hs-CRP low-risk, average-risk, and high-risk groups were 17.6% (200/1135), 25.9% (521/2015), and 29.7% (191/644), respectively. Spearman’s correlation analyses showed that there was significant positive correlation between hs-CRP levels and waist circumference, total triglycerides, total cholesterol, age, body mass index, and homeostasis model assessment of insulin resistance index. Stepwise regression analyses showed that participants in the hs-CRP high-risk group had a 46.2% higher risk of developing hypertension compared with those in the hs-CRP low-risk group (odds ratio: 1.462, 95% confidence interval: 1.018–2.101). Baseline systolic and diastolic blood pressure levels and waist circumference contributed the most to the development of hypertension with R2 of 0.076, 0.052, and 0.039, respectively, while hs-CRP had lower area under the curve (AUC) for hypertension, adding baseline BP and WC to the prediction model increased the AUC to 0.708 (95% CI: 0.681–0.735). Conclusion. This study revealed a weak positive association between CRP levels and future incidence of hypertension in the Chinese population. The combination of hs-CRP with baseline BP and waist circumference (WC) had a higher predictive value for hypertension (AUC: 0.708), but the predictive value was still limited.
format Article
id doaj-art-dc7e5fa60e4d4ad3a3452d1cb7204e0f
institution DOAJ
issn 2090-0392
language English
publishDate 2021-01-01
publisher Wiley
record_format Article
series International Journal of Hypertension
spelling doaj-art-dc7e5fa60e4d4ad3a3452d1cb7204e0f2025-08-20T03:23:56ZengWileyInternational Journal of Hypertension2090-03922021-01-01202110.1155/2021/3326349C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition SurveyBo Chen0Yuze Cui1Mengyun Lei2Wenlei Xu3Qiongjie Yan4Xiaotong Zhang5Minghui Qin6Shaoyong Xu7Evidence-Based Medicine CentreEvidence-Based Medicine CentreDepartment of EndocrinologyEvidence-Based Medicine CentreEvidence-Based Medicine CentreEvidence-Based Medicine CentreEvidence-Based Medicine CentreEvidence-Based Medicine CentreObjective. To explore the association between high sensitivity C-reactive protein (hs-CRP) levels and incident hypertension, as well as the association between hs-CRP levels and related covariates, in a Chinese adult population. Methods. This study was based on the China Health and Nutrition Survey, a continuing open, large-scale prospective cohort study. Adult participants who were free of hypertension were included at baseline survey in 2009 and were followed up in 2015 (follow-up rate: 77.45%). The hs-CRP was measured using the immunoturbidimetric method and divided into three groups: low-risk group (0 ≤ hs-CRP <1 mg/L), average-risk group (1 ≤ hs-CRP <3 mg/L), and high-risk group (3 ≤ hs-CRP ≤10 mg/L). Definite diagnosis of hypertension in the follow-up survey in 2015 was the endpoint event of this study. The areas under the curve (AUC) of the receiver operating characteristic (ROC) curve analyses were used to evaluate the predictive value of the hs-CRP. Results. 3794 participants were finally included as study sample, of whom 912 developed hypertension during a 6-year follow-up period (incidence: 24.1%). The incidences of hypertension in hs-CRP low-risk, average-risk, and high-risk groups were 17.6% (200/1135), 25.9% (521/2015), and 29.7% (191/644), respectively. Spearman’s correlation analyses showed that there was significant positive correlation between hs-CRP levels and waist circumference, total triglycerides, total cholesterol, age, body mass index, and homeostasis model assessment of insulin resistance index. Stepwise regression analyses showed that participants in the hs-CRP high-risk group had a 46.2% higher risk of developing hypertension compared with those in the hs-CRP low-risk group (odds ratio: 1.462, 95% confidence interval: 1.018–2.101). Baseline systolic and diastolic blood pressure levels and waist circumference contributed the most to the development of hypertension with R2 of 0.076, 0.052, and 0.039, respectively, while hs-CRP had lower area under the curve (AUC) for hypertension, adding baseline BP and WC to the prediction model increased the AUC to 0.708 (95% CI: 0.681–0.735). Conclusion. This study revealed a weak positive association between CRP levels and future incidence of hypertension in the Chinese population. The combination of hs-CRP with baseline BP and waist circumference (WC) had a higher predictive value for hypertension (AUC: 0.708), but the predictive value was still limited.http://dx.doi.org/10.1155/2021/3326349
spellingShingle Bo Chen
Yuze Cui
Mengyun Lei
Wenlei Xu
Qiongjie Yan
Xiaotong Zhang
Minghui Qin
Shaoyong Xu
C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey
International Journal of Hypertension
title C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey
title_full C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey
title_fullStr C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey
title_full_unstemmed C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey
title_short C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey
title_sort c reactive protein levels in relation to incidence of hypertension in chinese adults longitudinal analyses from the china health and nutrition survey
url http://dx.doi.org/10.1155/2021/3326349
work_keys_str_mv AT bochen creactiveproteinlevelsinrelationtoincidenceofhypertensioninchineseadultslongitudinalanalysesfromthechinahealthandnutritionsurvey
AT yuzecui creactiveproteinlevelsinrelationtoincidenceofhypertensioninchineseadultslongitudinalanalysesfromthechinahealthandnutritionsurvey
AT mengyunlei creactiveproteinlevelsinrelationtoincidenceofhypertensioninchineseadultslongitudinalanalysesfromthechinahealthandnutritionsurvey
AT wenleixu creactiveproteinlevelsinrelationtoincidenceofhypertensioninchineseadultslongitudinalanalysesfromthechinahealthandnutritionsurvey
AT qiongjieyan creactiveproteinlevelsinrelationtoincidenceofhypertensioninchineseadultslongitudinalanalysesfromthechinahealthandnutritionsurvey
AT xiaotongzhang creactiveproteinlevelsinrelationtoincidenceofhypertensioninchineseadultslongitudinalanalysesfromthechinahealthandnutritionsurvey
AT minghuiqin creactiveproteinlevelsinrelationtoincidenceofhypertensioninchineseadultslongitudinalanalysesfromthechinahealthandnutritionsurvey
AT shaoyongxu creactiveproteinlevelsinrelationtoincidenceofhypertensioninchineseadultslongitudinalanalysesfromthechinahealthandnutritionsurvey