Short term changes of hsCRP and proBNP in hypertensive emergencies

Objectives: Hypertension is associated with high cardiovascular risk. Both hsCRP and proBNP are known cardiovascular risk marker in the long run but less is known about short term regulation of these markers in hypertensive emergencies.

Methods: In 60 consecutive patients attending an emergency department due to hypertensive crisis (RR >160/100 and acute organ complications), hs CRP and proBNP were measured by ELISA's at admission, at day 3–4 and at day 7–10. All patients with hsCRP levels above 15mg/l were excluded from the study due to possible infection.

Results: HsCRP levels were elevated at admission (4.26 + 4.33mg/l) and declined to day 3–4 (3.05 + 3.4, p<0.05) and day 7–10 (3.6 + 4.07, n.s.). Men had higher hsCRP levels compared to women and patients with hypertensive cardiomyopathy in echocardiography had higher levels compared to patients without. ProBNP levels were clearly elevated at admission (317.6 + 505.3 pg/ml) and declined to day 3–4 (203 + 461.6, p<0.01) and day 7–10 (141.1 + 210.5, p<0.01 to admission). Patients with hypertensive cardiomyopathy had higher proBNP levels (at admission 445.4 + 616.5 pg/ml) compared to those without cardiomyopathy (281.6 + 503.3 pg/ml, p<0.05) and women had higher proBNP levels compared to men.

Conclusion: In hypertensive emergencies proBNP levels correspond to levels described in heart failure NYHA II-IV and declined significantly under antihypertensive therapy. In addition, we found an acute decline of hsCRP in the short term under antihypertensive therapy. These data may be of importance in the clinical setting of hypertensive emergencies and in the interpretation of data from epidemiological studies concerning long term cardiovascular risk.