The relationship between CRP/Albumin ratio and subclinical atherosclerosis in newly diagnosed hypertensive patients

ABSTRACT Title: The Relationship Between CRP/Albumin Ratio and Subclinical Atherosclerosis in Newly Diagnosed Hypertensive Patients Introduction and Aim: Hypertension (HT) is one of the leading causes of morbidity and mortality due to cardiovascular remodeling. The underlying pathophysiological mechanism of cardiovascular remodeling is inflammatory processes, which contribute to the development of atherosclerosis. Early detection of the atherosclerotic process that plays a role in the formation of morbidity and mortality is of utmost importance, and various inflammatory markers have been studied in this regard. In this study, we aimed to evaluate the relationship between previously uninvestigated CRP/Albumin ratio (CAR) and subclinical atherosclerosis (SCAS) in newly diagnosed hypertensive patients. Materials and Methods: Newly diagnosed hypertensive patients who presented to the outpatient clinic of the Department of Cardiology at Erzincan Binali Yildirim University Mengucek Gazi Training and Research Hospital between January 2021 and January 2022 were included in our study. A study population was formed with 200 patients who met the inclusion and exclusion criteria for the first-time diagnosis of HT. Detailed medical histories and physical examinations were obtained, and routine hematological and biochemical parameters were studied. CAR, which forms the basis of our study, was calculated as CRP/Albumin ratio multiplied by 10. Epicardial fat thickness was measured with Vivid S5, GE device using a 3S RS (1.5-4 MHz) echocardiography probe. Carotid intima-media thickness (CIMT) was measured with Sonoscape S2, Sonoscape vascular probe (5-12 MHz). Results: The median value of the mean right and left CIMT measurements of the total of 200 patients included in our study was found to be 0.75 mm. Patients with a median value of 0.75 mm or higher were defined as the supramedian CIMT group, while patients with a median value below 0.75 mm were defined as the inframedian CIMT group. The supramedian CIMT group had 120 patients (60%), while the inframedian CIMT group had 80 patients (40%). When compared with the inframedian CIMT group, it was determined that age, gender, LDL cholesterol, and triglyceride levels were significantly higher in the supramedian CIMT group (p<0.05). CARx10 was significantly higher in the supramedian CIMT group compared to the inframedian CIMT group (respectively 0.12 (0.07-0.49) vs. 0.07 (0.07-0.10), p<0.001). Epicardial adipose tissue thickness (EATT) was also significantly higher in the supramedian 4 CIMT group compared to the inframedian CIMT group (respectively 4.1 (3.6-4.6) vs. 3.3 (2.1- 3.8), p<0.001). CIMT was significantly correlated with CAR and EATT. Furthermore, CARx10 and EATT were found to be independent predictors of CIMT. Conclusion: In our study, we found that CAO can be used as a novel marker for predicting subclinical atherosclerosis (SCAS) in newly diagnosed hypertensive patients. Thus, we believe that the detection of coronary artery disease at the stage of subclinical atherosclerosis in hypertensive patients can reduce cardiovascular mortality and morbidity. However, larger scale studies supporting our findings are needed. Key Words: Newly Diagnosed Hypertension, Subclinical Atherosclerosis, CAR, EATT.