Predictive value of C-reactive protein for progression from prehypertension to hypertension: a prospective cohort study based on the CHARLS database.
5 affiliations
- 1Faculty of Medicine, School of Traditional Chinese Medicine, Yangzhou University, No. 136, Jiangyang Middle Road, Yangzhou, 225009, PR China. [email protected].
- 2Department of Cardiology, Yangzhou Hospital Affiliated to Nanjing University of Chinese Medicine, No. 577, Wenchang Middle Road, Yangzhou, 225000, PR China.
- 3Faculty of Medicine, School of Traditional Chinese Medicine, Yangzhou University, No. 136, Jiangyang Middle Road, Yangzhou, 225009, PR China.
- 4Department of Cardiology, Yangzhou Hospital Affiliated to Nanjing University of Chinese Medicine, No. 577, Wenchang Middle Road, Yangzhou, 225000, PR China. [email protected].
- 5Department of Cardiology, Yangzhou Hospital Affiliated to Nanjing University of Chinese Medicine, No. 577, Wenchang Middle Road, Yangzhou, 225000, PR China. [email protected].
Abstract
Background
The key to preventing and treating hypertension is predicting the progression of prehypertension and implementing preventive and control measures. Whether C-reactive protein (CRP) can predict the progression from prehypertension to hypertension remains to be confirmed.Methods
Based on prospective data from CHARLS from 2011 to 2015, 1,236 middle-aged and elderly individuals with prehypertension were enrolled and stratified into three groups according to their baseline CRP levels using predefined CRP categories. We employed interval-censored Cox models and restricted cubic spline analysis to assess the association between CRP level and hypertension risk, as well as model improvement metrics after incorporating CRP.Results
During the 4-year follow-up period, 269 participants developed incident hypertension, accounting for 21.8% of the study population. In the adjusted interval-censored Cox model, higher log-transformed CRP was associated with a higher risk of hypertension (HR = 1.34; 95% CI: 1.07-1.68). Because the restricted cubic spline analysis suggested a nonlinear pattern (P for nonlinearity = 0.040), this estimate should be interpreted as an overall summary rather than a constant risk increase across the full CRP range. In the analysis based on clinical CRP categories, participants with CRP > 3 mg/L had a higher risk than those with CRP < 1 mg/L (HR = 1.61; 95% CI: 1.15-2.26). Subgroup analyses showed no significant interactions across age, sex, BMI, systolic blood pressure, or remnant cholesterol groups. After adding CRP to the conventional risk model, the C-index increased from 0.626 to 0.634.Conclusions
Elevated CRP levels were associated with the progression from prehypertension to hypertension among middle-aged and elderly adults. Adding CRP to conventional risk factors provided modest additional predictive information. CRP may serve as a supplementary indicator for identifying individuals who need closer follow-up, but it should not be used alone for risk assessment.
Related
- Continuous Associations and Predictive Performance of Electrocardiographic Voltage- and Product-Based Indices for Incident Hypertension: A Prospective Cohort Study.
- Associations of the Triglyceride-Glucose Index With the Risk of Hypertension and Prehypertension
- Longitudinal Systemic C-Reactive Protein and Risk of Progression to Advanced Age-Related Macular Degeneration
- Combined elevated C-reactive protein and detectable plasma RNA has predictive value for hospitalization during an outpatient COVID-19 convalescent plasma clinical trial
- Joint association of the C-reactive protein-triglyceride-glucose index and frailty with incident stroke: a nationwide prospective cohort study
BibTeX
@article{fan2026predictive,
title = {{Predictive value of C-reactive protein for progression from prehypertension to hypertension: a prospective cohort study based on the CHARLS database.}},
author = {Yadong Fan and Chao Zhang and Yulan Qian and Zijie Zhu and Xue Tian and Xuechen Cui and Mengxin Wang and Daocheng Wang and Gang Xue},
journal = {BMC cardiovascular disorders},
year = {2026},
month = aug,
doi = {10.1186/s12872-026-06375-7},
url = {https://europepmc.org/article/MED/42967993},
note = {CC BY},
}
RIS
TY - JOUR
TI - Predictive value of C-reactive protein for progression from prehypertension to hypertension: a prospective cohort study based on the CHARLS database.
AU - Yadong Fan
AU - Chao Zhang
AU - Yulan Qian
AU - Zijie Zhu
AU - Xue Tian
AU - Xuechen Cui
AU - Mengxin Wang
AU - Daocheng Wang
AU - Gang Xue
PY - 2026
DA - 2026/08/05
JO - BMC cardiovascular disorders
DO - 10.1186/s12872-026-06375-7
UR - https://europepmc.org/article/MED/42967993
AB - Background The key to preventing and treating hypertension is predicting the progression of prehypertension and implementing preventive and control measures. Whether C-reactive protein (CRP) can predict the progression from prehypertension to hypertension remains to be confirmed.Methods Based on prospective data from CHARLS from 2011 to 2015, 1,236 middle-aged and elderly individuals with prehypertension were enrolled and stratified into three groups according to their baseline CRP levels using predefined CRP categories. We employed interval-censored Cox models and restricted cubic spline analysis to assess the association between CRP level and hypertension risk, as well as model improvement metrics after incorporating CRP.Results During the 4-year follow-up period, 269 participants developed incident hypertension, accounting for 21.8% of the study population. In the adjusted interval-censored Cox model, higher log-transformed CRP was associated with a higher risk of hypertension (HR = 1.34; 95% CI: 1.07-1.68). Because the restricted cubic spline analysis suggested a nonlinear pattern (P for nonlinearity = 0.040), this estimate should be interpreted as an overall summary rather than a constant risk increase across the full CRP range. In the analysis based on clinical CRP categories, participants with CRP > 3 mg/L had a higher risk than those with CRP < 1 mg/L (HR = 1.61; 95% CI: 1.15-2.26). Subgroup analyses showed no significant interactions across age, sex, BMI, systolic blood pressure, or remnant cholesterol groups. After adding CRP to the conventional risk model, the C-index increased from 0.626 to 0.634.Conclusions Elevated CRP levels were associated with the progression from prehypertension to hypertension among middle-aged and elderly adults. Adding CRP to conventional risk factors provided modest additional predictive information. CRP may serve as a supplementary indicator for identifying individuals who need closer follow-up, but it should not be used alone for risk assessment.
SN - 1471-2261
ER -