Study of relationship between CRP, bilirubin and selected anthropometric parameters with hypertension
Abstract
Background: There are many recent studies showing that hypertension, and cardio-vascular disease is linked to inflammation. The higher CRP levels are significantly correlated with hypertension. CRP estimation is used as a surrogate marker in evaluation and predicting the prognosis of all hypertensive patients. Many of the epidemiologic studies had shown the association of CRP levels with future cardiovascular events and hypertension. Bilirubin has been shown to be an effective antioxidant both in vitro and in vivo. The excess body fat and distribution is an important contributor to the association between obesity and high BP.
Aims and objectives: The objective was to study the relationship between CRP, Bilirubin and selected anthropometric parameters among both hypertensive and non hypertensive subjects.
Methods: We have conducted a hospital based descriptive observational study using purposive non random sampling method on 150 subjects; 87 hypertensive and 77 were non hypertensive. Age, systolic BP, diastolic BP, weight, height, waist circumference, hip circumference, SAD, total Bilirubin, T cholesterol, HDL-C, Triglycerides, LDL-C were primary continuous variables. BMI, WHR, WHtR were taken as secondary variables.
Results: CRP, Waist circumference, WHtR and SAD have a positive correlation with both systolic and diastolic BP. Odds ratio was 12.18 for CRP. Total Bilirubin levels have a negative correlation with systolic and diastolic BP. Odds ratio was 7.81. Diastolic BP had positive correlation with Weight, Hip circumference and BMI.
Conclusion: We had demonstrated elevated CRP, low Bilirubin levels, abnormal SAD and Waist circumference were associated with blood pressure levels. These parameters are useful and cost-effective tool for predicting and evaluating Hypertension.
Downloads
References
2. Androulakis ES, Tousoulis D, Papageorgiou N, Tsioufis C, Kallikazaros I, Stefanadis C. Essential hypertension: is there a role for inflammatory mechanisms? Cardiol Rev 2009 Sep-Oct; 17(5): 216–21.
3. Rajesh K, Suchet, Kochhar S. C-reactive protein and severity of hypertension. JARBS 2013; 5 (4) :331-35.
4. Hage FG. C-reactive protein and hypertension. J Hum Hypertens 2014; 28: 410–15.
5. Tatami Y , Suzuki S , Ishii H, Shibata Y, Osugi N, Ota T et al. Impact of serum bilirubin levels on carotid
atherosclerosis in patients with coronary artery disease. IJC Metab Endocr 2014;5: 24–27.
6. Sacerdoti D, Escalante B, Abraham NG, McGiff JC, Levere RD, Schwartzman ML. Treatment with tin prevents the development of hypertension in spontaneously hypertensive rats. Science.1989 Jan ;243(4889): 388–90.
7. Stec DE, Drummond HA, Gousette MU, Storm MV, Abraham NG, Csongradi E. Expression of heme
oxygenase-1 in thick ascending loop of henle attenuates angiotensin II-dependent hypertension. J Am Soc
Nephrol. 2012; 23 :834–41.
8. World Health Organization. World Health Report. Obesity, high blood pressure, high cholesterol, alcohol and
tobacco. The World Health Organization’s Response. Available at http://www.who.int/whr/media_centre/factsheet3/en/
9. Oliveira JS, Amorim PRS, Rosado GP, Ribeiro RCL, Franceschini SCC, Santos TM , Rosado LE. Waist Circumference and Sagittal Abdominal Diameter as Markers of Blood Pressure Abnormality. J Hum Nutr Food
Sci 2014;2(2): 1031.
10. Vander Kooy K, Leenen R, Seidell JC, et al.:Abdominal diameters as indicators of visceral fat:Comparison between magnetic resonance imaging and anthropometry. Br J Nutr 1993 Jul; 70(1): 47–58.
11. Sampaio LR, Simões EJ, Assis AMO, Ramos LR. Validity and reliability of the SAD as a predictor of visceral abdominal fat. Arq Brase Endocrinol Metabol 2007 Aug; 51(6): 980-86.
12. World Health Organization. Hypertension control. Report of WHO expert Committee. Geneva, Switzerland: World Health Organ Tech Rep Ser.1996;862:1-83.
13. Bose K, Ghosh A, Roy S, Gangopadhyay S. Blood pressure and waist circumference: an empirical study of the effects of waist circumference on blood pressure among Bengalee male jute workers of Belur, West Bengal, India. J Physiol Anthropol Appl Human Sci 2003 Jul; 22(4) : 169-73.
14. Shanthirani CS, Pradeepa R, Deepa R, Premalatha G,Saroja R, Mohan V. Prevalence and risk factors of hypertension in selected South Indian population – the Chennai Urban Population Study. J Assoc Physicians India 2003 Jan; 51 : 20-7.
15. Gupta R, Mehrishi S. Waist-hip ratio and blood pressure correlation in an urban Indian population. J Indian Med Assoc 1997 Jul; 95(7) : 412-5.
16. Sharda M, Nagar D, Soni A. Sagittal Abdominal Diameter as a Predictor of Metabolic Syndrome in Elderly: J Indian Acad Geriatr 2014 Mar; 10:5-9.
17. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42: 1206-52.
18. World Health Organization. The Asia-Pacific Perspective: Redefining Obesity and its treatment. Geneva, Switzerland: WHO; 2000. Available from http://www.wpro.who.int/nutrition/documents/docs/Redefiningobesity.pdf
19. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome-a new worldwide definition. The Lancet 2005; 366 (9491); 1059-62.
20. Noble RE. Waist to hip ratio versus BMI as predictors of cardiac risk in obese adult women. West J Med. 2001 Apr; 174(4): 240-41.
21. Ris´erus U, Faire U, Berglund L, Hell´enius ML. Sagittal Abdominal Diameter as a Screening Tool in Clinical Research: Cutoffs for Cardiometabolic Risk: J Obes 2010 March;1-7.
22. Sung KC , Suh JY, Kim BS, Kang JH, Kim H, Lee MH et al. High sensitivity C-reactive protein as an independent risk factor for essential hypertension. Am J Hypertens.2003;16(6): 429–33.
23. Schillaci G, Pirro M, Gemelli F, Pasqualini L, Vaudo G, Marchesi S et al. Increased C-reactive protein concentrations in never-treated hypertension: the role of systolic and pulse pressures. J Hypertens. 2003 ; 21 :1841-46.
24. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto Jr AM, Kastelein JJ et al.Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial.Lancet 2009; 373(9670): 1175–82.
25. Fliser D, Buchholz K, Haller H. Antiinflammatory effects of angiotensin II subtype 1 receptor blockade in hypertensive patients with microinflammation. Circulation 2004; 110(9): 1103–07.
26. Ridker PM, Danielson E, Rifai N, Glynn RJ. Valsartan, Blood pressure reduction, and C-reactive protein: Primary report of the Val-MARC trial. Hypertension 2006; 48(1):73–79.
27. Bergmann K, Pachota E, Sypniewska GO. Association of serum total bilirubin with traditional and novel cardiovascular risk factors in apparently healthy subjects. Folia Med. Copernicana 2015; 3 (1): 26–31.
28. Souza NC, Oliveira EP. Sagittal abdominal diameter shows better correlation with cardiovascular risk factors than waist circumference and BMI.: J Diabetes Metab Disord 2013; 12:41.
29. Oliveira JS, Amorim PRS, Rosado GP, Ribeiro RCL, Franceschini SCC, Santos TM , Rosado LE. Waist Circumference and Sagittal Abdominal Diameter as Markers of Blood Pressure Abnormality. J Hum Nutr Food Sci 2014;2(2): 1031.
OAI - Open Archives Initiative
