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Aortic and vascular disease
Original research article
Inflammation markers and risk of developing hypertension: a meta-analysis of cohort studies
  1. Ahmad Jayedi1,
  2. Kazem Rahimi2,3,
  3. Leonelo E Bautista4,
  4. Milad Nazarzadeh2,5,
  5. Mahdieh Sadat Zargar6,
  6. Sakineh Shab-Bidar7
  1. 1 Food (salt) Safety Research Center, Semnan University of Medical Sciences, Semnan, Iran
  2. 2 George Institute for Global Health, University of Oxford, Oxford, UK
  3. 3 Deep Medicine, Oxford Martin School, University of Oxford, Oxford, UK
  4. 4 Department of Population Health, School of Medicine, University of Wisconsin at Madison, Wisconsin, USA
  5. 5 Collaboration Center of Meta-Analysis Research, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
  6. 6 Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
  7. 7 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
  1. Correspondence to Dr Sakineh Shab-Bidar, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14155/6117, Iran; s_shabbidar{at}tums.ac.ir

Abstract

Objective To systematically assess the association of circulating inflammation markers with the future risk of hypertension.

Methods We did a systematic literature search of PubMed and Scopus, from database inception to July 10, 2018. Prospective and retrospective cohort studies evaluating the association of circulating C reactive protein (CRP), high-sensitive CRP (hs-CRP), interleukin 6 (IL-6) and IL-1β to the risk of developing hypertension in the general population were included. The relative risks (RRs) for the top versus bottom tertiles of circulating biomarkers were calculated using a fixed-effects/random-effects model. A potential non-linear dose-response association was tested.

Results Fourteen prospective cohort studies, two retrospective cohort studies and five nested case-control studies involving 142 640 participants and 20 676 cases were identified. The RR for the third versus first tertiles of circulating CRP was 1.23 (95% CI 1.11 to 1.35; I2=59%, n=12). The association remained unchanged after adjustment for body mass index. The RRs for other biomarkers were as follows: hs-CRP (RR 1.20, 95% CI 1.02 to 1.37; I2=74%, n=7), IL-6 (RR 1.51, 95% CI 1.30 to 1.71; I2=0%, n=5), and IL-1β (RR 1.22, 95% CI 0.92 to 1.51; I2=0%, n=3). A non-linear dose-response meta-analysis demonstrated that the risk of hypertension increased linearly with increasing circulating inflammation markers, even within the low-risk and intermediate-risk categories.

Conclusions Higher levels of circulating CRP, hs-CRP and IL-6, but not IL-1β, were associated with the risk of developing hypertension. The association persisted in subgroups of studies defined by major sources of heterogeneity.

  • inflammatory markers
  • hypertension
  • meta-analysis

https://doi.org/10.1136/heartjnl-2018-314216

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    Footnotes

    • Contributors AJ designed the research, screened articles, extracted and analysed data, and wrote the paper; MSZ screened articles, extracted data and wrote the paper; KR, LEB and MN critically revised the manuscript and contributed to the interpretation of the results; SS-B wrote paper, revised the manuscript, and had primary responsibility for the final content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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