Objective: To investigate the association between high sensitivity C-reactive protein (hsCRP) level and new-onset hypertension in different age groups. Methods: This was a prospective cohort study involving non-hypertensive population in Kailuan Group community who participated in health examination between 2006 and 2007.Follow-up was conducted every 2 years, and the time of new onset of hypertension was used as the endpoint of follow-up. The endtime of follow-up for patients without hypertension was the time of death or the last follow-up (December 31, 2017).According to the baseline hsCRP level, the participants were divided into low-risk group (hsCRP<1.0 mg/L), medium-risk group (hsCRP ≥1.0 and ≤3.0 mg/L), and high-risk group (hsCRP>3.0 mg/L), and further stratified by age. Kaplan-Meier method was used to calculate the cumulative incidence of hypertension in each group. Multivariate Cox regression model was used to analyze the association between hsCRP level and new-onset hypertension. Results: A total of 51 179 participants were included in this study, including 38 606 males (75.43%) with an average age of (48.1±12.2) years. The baseline hsCRP was 0.64 (0.25, 1.60) mg/L. The baseline hsCRP was 0.30 (0.16, 0.59), 1.57 (1.20, 2.10), 5.17 (3.80, 7.10) mg/L respectively in low-, medium- and high-risk groups. During the follow-up of (8.1±2.2) years, a total of 9 523 (18.60%) patients developed hypertension, and the cumulative incidence rates of low-, medium- and high-risk groups were 17.41%, 20.48% and 20.73%, respectively. The cumulative incidence of hypertension in low-, medium- and high-risk groups of<45, 45-54, 55-64, ≥65 years old were 13.53%, 15.82%, 16.76%; 19.27%, 22.84%, 21.62%; 21.55%, 24.19%, 24.88%;20.20%, 22.35%, 19.11%, respectively. Except for people aged ≥65 years, there were significant differences in the cumulative incidence of hypertension in low-, medium- and high-risk groups (all P<0.05).Multivariate Cox regression analysis showed that the risk of new-onset hypertension in the high risk group was 1.11 times higher than that in the low risk group (HR=1.11, 95%CI 1.05-1.18). The risk of new-onset hypertension in the high-risk group was 1.22 times (HR=1.22, 95%CI 1.08-1.38), 1.14 times (HR=1.14, 95%CI 1.04-1.26), 1.16 times (HR=1.16, 95%CI 1.04-1.30), and 1.02 times (HR=1.02, 95%CI 0.86-1.20) of the low-risk group, in the<45, 45-54, 55-64, and ≥65 years old groups, respectively. Conclusion: Higher hsCRP level is a risk factor for new-onset hypertension, and the risk of developing hypertension caused by elevated hsCRP is age-dependent.
目的： 探讨不同年龄段人群超敏C反应蛋白（hsCRP）水平与新发高血压的关联。 方法： 该研究为前瞻性队列研究，纳入参加2006至2007年度健康体检的开滦集团社区非高血压人群。每2年随访1次，以新发高血压时间作为随访终点，未发现高血压者随访截止时间为死亡时间或随访结束时间（2017年12月31日）。根据基线hsCRP水平将被试者分为低风险组（hsCRP<1.0 mg/L）、中风险组（hsCRP ≥1.0且≤3.0 mg/L）和高风险组（hsCRP>3.0 mg/L），并按年龄进一步分层（每10岁1组）。采用Kaplan-Meier法计算各组人群高血压累积发病率，采用多因素Cox回归模型分析hsCRP水平与新发高血压的关联。 结果： 研究纳入51 179人，其中男性38 606人（75.43%），年龄（48.1±12.2）岁，基线hsCRP为0.64（0.25，1.60）mg/L。低、中、高风险组各31 791、12 419、6 969人，基线hsCRP分别为0.30（0.16，0.59）、1.57（1.20，2.10）、5.17（3.80，7.10）mg/L。随访（8.1±2.2）年，期间共9 523（18.60%）人新发高血压，低、中、高风险组人群的累积发病率分别为17.41%、20.48%、20.73%，低、中、高风险组<45、45~54、55~64、≥65岁人群高血压的累积发病率分别为13.53%、15.82%、16.76%，19.27%、22.84%、21.62%，21.55%、24.19%、24.88%，20.20%、22.35%、19.11%，除≥65岁人群外，其余各年龄段低、中、高风险组人群高血压累积发病率差异均有统计学意义（P均<0.05）。多因素Cox回归模型分析结果显示，在总人群中高风险组人群新发高血压的风险是低风险组人群的1.11倍（HR=1.11，95%CI 1.05~1.18）；在<45岁、45~54岁、55~64岁和≥65岁人群中高风险组新发高血压的风险分别为低风险组的1.22倍（HR=1.22，95%CI 1.08~1.38）、1.14倍（HR=1.14，95%CI 1.04~1.26）、1.16倍（HR=1.16，95%CI 1.04~1.30）和1.02倍（HR=1.02，95%CI 0.86~1.20）。 结论： hsCRP高水平是新发高血压的危险因素，hsCRP升高所致高血压发病风险呈现出年龄依赖性。.