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The relationship between inflammation, obesity and risk for hypertension in the Multi-Ethnic Study of Atherosclerosis (MESA)

Journal of Human Hypertension volume 25, pages 73–79 (2011)Cite this article

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Abstract

It has been suggested that inflammation is important in the aetiology of hypertension and that this may be most relevant among obese persons. To study this, we examined the independent relationships between obesity, inflammation-related proteins (interleukin-6 (IL-6), C-reactive protein (CRP) and fibrinogen) and risk for hypertension in the Multi-Ethnic Study of Atherosclerosis (MESA). Hypertension status, defined as a blood pressure ⩾140/90 mm Hg or a history of hypertension and use of blood pressure medications, was determined at baseline and two subsequent exams over 5 years. Among 3543 non-hypertensives at baseline, 714 individuals developed incident hypertension by Exam 3. Cox proportional hazard models were used to determine the relationship between baseline levels of IL-6, CRP and fibrinogen and future risk of hypertension. One s.d. difference in baseline concentration of IL-6, CRP or fibrinogen was associated with 20–40% greater risk of incident hypertension. This risk was attenuated after accounting for other hypertension risk factors (hazard ratio (HR) IL-6: 1.13 (95% CI: 1.04–1.23); CRP: 1.11 (95% CI: 1.02–1.21); fibrinogen 1.0 (95% CI: 0.92–1.08)). Conversely, obesity was an independent risk factor for hypertension risk, minimally impacted by other covariates, including IL-6 and CRP (HR 1.72 (95% CI: 1.36–2.16)). IL-6 and CRP did not modify the relationship between obesity and hypertension, though an adjusted twofold greater risk was observed for obese individuals with a CRP >3 mg l−1 compared with CRP <1 mg l−1. The relationship between inflammation-related proteins and hypertension risk was predominantly explained by other hypertension risk factors. Obesity, independent of inflammation, remained a potent risk factor for future hypertension.

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Acknowledgements

We thank the other investigators, the staff and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org. Source of Funding: This research was supported by contracts N01-HC-95159 through N01-HC-95166 and Grant NHLBI T32 HL076132-01 from the National Heart, Lung and Blood Institute.

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Authors and Affiliations

  1. Department of Internal Medicine/Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    S G Lakoski

  2. Department of Medicine, University of Vermont, Burlington, VT, USA

    M Cushman

  3. Department of Medicine and Epidemiology, University of Washington, Seattle, WA, USA

    D S Siscovick

  4. Ciccarone Preventive Cardiology Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    R S Blumenthal

  5. Department of Medicine, Columbia University, New York, NY, USA

    W Palmas

  6. Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA

    G Burke

  7. Department of Internal Medicine/Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    D M Herrington

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  1. S G Lakoski
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  2. M Cushman
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  3. D S Siscovick
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  4. R S Blumenthal
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  5. W Palmas
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  6. G Burke
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  7. D M Herrington
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Correspondence to S G Lakoski.

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Lakoski, S., Cushman, M., Siscovick, D. et al. The relationship between inflammation, obesity and risk for hypertension in the Multi-Ethnic Study of Atherosclerosis (MESA). J Hum Hypertens 25, 73–79 (2011). https://doi.org/10.1038/jhh.2010.91

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