Modulatory Effect of Inflammation on Blood Pressure Reduction via Therapeutic Lifestyle Change

Ochsner J. 2009 Winter;9(4):175-80.


Purpose: Since inflammatory status, as determined by C-reactive protein (CRP) levels, is correlated with many cardiovascular (CV) disease risk factors and major CV events, we sought to determine if median levels of CRP can modulate blood pressure changes as well as other CV risk factors that are typically improved by therapeutic lifestyle changes with formal cardiac rehabilitation and exercise training (CRET) programs.

Methods: We retrospectively evaluated CRP status and standard CV risk factors both before and after formal, phase II CRET programs (12 weeks; 36 educational and exercise sessions) in 635 consecutive patients with coronary artery disease after major CV events.

Results: The median CRP level at baseline was 3.2 mg/L (range, 0.2-80.1 mg/L; mean, 5.8±8.4 mg/L). After CRET, both the patients with high and those with low CRP concentrations exhibited statistically significant improvements in most CV risk factors when their CRP levels were divided by median levels. However, systolic, diastolic, and mean arterial blood pressure improved in patients with low CRP levels (each by -4%) but did not change significantly in patients with high CRP levels. In multiple regression models, only young age, low CRP levels, and low body mass index were significant independent predictors of improved mean arterial blood pressure after CRET.

Conclusions: In contrast to patients with coronary artery disease and low levels of CRP, patients with high baseline CRP levels did not demonstrate significant reductions in blood pressure after therapeutic lifestyle changes via formal CRET programs.

Keywords: Blood pressure; exercise; inflammation.