Hypersensitive C-reactive Protein as a Potential Indicator for Predicting Left Ventricular Hypertrophy in Elderly Community-Dwelling Patients with Hypertension

Abstract

Abstract BACKGROUND The aim of this study was to investigate the relationship between Hypersensitive C-reactive protein (hs-CRP) and left ventricular hypertrophy (LVH) in elderly patients with hypertension in the community. METHODS A prospective study was conducted, involving the recruitment of 365 elderly hypertensive residents from five communities. The participants were divided into two groups: an LVH group (n=134) and a non-LVH group (n=231), based on the left ventricular mass index (LVMI) determined by echocardiography. Spearman correlation analysis was used to assess the relationship between hs-CRP and LVH. Univariate and Multivariate analysis was performed to detect variables associated with LVH. The diagnostic value of hs-CRP for LVH was expressed as the area under the receiver operating characteristic (ROC) curve. RESULTS The incidence of LVH in elderly hypertension patients in the community was 36.7%. The hs-CRP levels were significantly higher in subjects with LVH compared to those without LVH (1.9 [0.8, 2.9] vs. 0.7 [0.4, 1.4], P=0.002). Spearman correlation analysis demonstrated a positive correlation between hs-CRP and LVMI (r=0.246, P<0.001), as well as with IVST (r=0.246, P<0.001) and LVPWT (r=0.172, P=0.001). Among elderly hypertensive residents in the community, the cut-off value of hs-CRP for diagnosing LVH was 1.25 mg/L (sensitivity: 57.5%; specificity: 78.4%), and the area under the ROC curve for hs-CRP to predict LVH was 0.710 (95%CI: 0.654-0.766; P<0.001). After adjusting for various confounding factors, the multivariate logistic regression model revealed that hs-CRP levels ≥1.25 mg/L were independent risk factors for the development of LVH (OR=3.490; 95%CI, 2.097-5.809; P<0.001). CONCLUSIONS This community-based cohort of elderly hypertensive individuals demonstrates a strong association between hs-CRP levels and the presence of LVH. The hs-CRP ≥1.25 mg/L may serve as an independent predictor for LVH in hypertensive subjects and exhibit good diagnostic efficacy for LVH.