Plasma Inflammatory Markers and the Risk of Developing Hypertension in Men

Background Several cross‐sectional, but few prospective, studies suggest that inflammation may be involved in the development of hypertension. We examined markers of inflammation—high‐sensitivity C‐reactive protein, interleukin‐6, and soluble intercellular adhesion molecule‐1—and a marker of fibrinolysis, D‐dimer, for their associations with incident hypertension in the Physicians' Health Study. Methods and Results Baseline blood values and information on hypertension‐related risk factors were collected in 1982. Incident hypertension was defined as self‐reported initiation of antihypertensive treatment, systolic blood pressure ≥140 mm Hg, or diastolic blood pressure ≥90 mm Hg during follow‐up. With use of a nested case‐control design, 396 cases of incident hypertension and controls free of hypertension were matched 1:1 on age (mean 47.4 years) and follow‐up time. In crude matched‐pair analyses, the conditional relative risks of hypertension in the second through fourth versus the lowest quartiles for plasma high‐sensitivity C‐reactive protein were 1.27, 1.73, and 1.81 ( P trend =0.01); for interleukin‐6, 1.22, 1.02, and 1.51 ( P trend =0.06); for soluble intercellular adhesion molecule‐1, 1.00, 0.80, and 1.26 ( P trend =0.37); and for D‐dimer, 1.61, 1.81, and 1.52 ( P trend =0.46). Multivariable adjustment attenuated the estimates. The multivariable relative risks of hypertension in the second through fourth compared to the lowest quartiles of high‐sensitivity C‐reactive protein were 1.24, 1.60, and 1.47 ( P trend =0.20); for interleukin‐6, 1.08, 0.92, and 1.36 ( P trend =0.16); for soluble intercellular adhesion molecule‐1, 0.89, 0.79, and 1.18 ( P trend =0.55); and for D‐dimer, 1.48, 1.68, and 1.38 ( P trend =0.63). Conclusions Elevated plasma inflammatory markers and D‐dimer were nonsignificantly associated with a higher risk of hypertension among initially healthy men.