The relationship between C-reactive protein/albumin ratio and mortality in hypertensive patients: A national cohort study

Nutr Metab Cardiovasc Dis. 2024 Jul;34(7):1601-1609. doi: 10.1016/j.numecd.2024.02.011. Epub 2024 Feb 27.

Abstract

Background and aims: The impact of inflammation on the prognosis of hypertension has received some attention. The current study examined the association between C-reactive protein to albumin ratio (CAR), a novel indicator of inflammatory response, and mortality in individuals with hypertension.

Methods and results: A total of 9561 eligible individuals diagnosed with hypertension were included in the final analysis. CAR was calculated as ratio of C-reactive protein to serum albumin concentration. Patients were categorized into tertiles based on their baseline CAR levels. The Kaplan-Meier survival method was employed to compare the survival times of patients throughout the follow-up period. Multivariable analysis was conducted using the Cox proportional regression model. In the entire study population, 3262 (27%) experienced all-cause mortality. Patients in tertile 3 exhibited a higher risk of mortality (23% vs. 28% vs. 31%, P < 0.001) in comparison to those in the other tertiles. The findings from the multivariable Cox regression analysis demonstrated that when patients in tertile 1 were used as the reference group, the highest CAR tertile displayed a 60% increased risk of all-cause mortality (HR, 1.60 [95%CI, 1.23-2.09] P < 0.001).

Conclusion: Among hypertensive patients, elevated CAR was found to be associated with an increased risk of all-cause mortality. Therefore, CAR might be used for risk stratification within this population, facilitating the implementation of closer follow-up and the optimization of treatment strategies.

Keywords: C-reactive protein/albumin ratio; Hypertension; Inflammation; Mortality.

MeSH terms

  • Adult
  • Aged
  • Biomarkers* / blood
  • Blood Pressure
  • C-Reactive Protein* / analysis
  • C-Reactive Protein* / metabolism
  • Cause of Death
  • Female
  • Humans
  • Hypertension* / blood
  • Hypertension* / diagnosis
  • Hypertension* / mortality
  • Inflammation / blood
  • Inflammation / diagnosis
  • Inflammation / mortality
  • Inflammation Mediators / blood
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Serum Albumin, Human* / analysis
  • Time Factors

Substances

  • C-Reactive Protein
  • Biomarkers
  • ALB protein, human
  • Serum Albumin, Human
  • Inflammation Mediators