On-treatment C-reactive protein and HDL cholesterol levels in patients at intermediate cardiovascular risk: Impact on carotid intima-media thickness

AimsStatin therapy is followed by reductions in carotid intima-media thickness (CIMT) and C-reactive protein (CRP) levels, but a significant number of treated patients still have increased CIMT. We investigated whether on-treatment levels of CRP are associated with CIMT in hypercholesterolemic patients receiving statin therapy. The influence of blood pressure and anti-hypertensive therapy on the association between CRP and CIMT was evaluated.Main methodsThe assessment of cardiovascular risk factors, CRP and CIMT, was performed in a cross-sectional study of 240 hypercholesterolemic patients at intermediate cardiovascular risk under statin therapy; 125 patients received only a statin (statin group) and 115 also anti-hypertensive therapy (combined therapy group).Key findingsLogarithmically transformed CRP (β = 0.17, p = 0.01) and HDL cholesterol levels (β = − 0.27, p < 0.001) were correlates of CIMT, irrespective of confounders. High CRP levels (> 3 mg/L) were associated with a 2.7-fold increased risk of having high CIMT (> 1.25 mm). High CIMT was present in a high percentage of patients not at target for cholesterol and blood pressure levels (61%). Patients in the statin group had lower Framingham risk and CIMT than those in the combined therapy group. In the statin group, logarithmically transformed CRP (β = 0.28, p = 0.004) and HDL cholesterol (β = − 0.21, p = 0.03) were associated with CIMT. In the combined therapy group, HDL cholesterol was the only significant CIMT correlate (β = − 0.33, p = 0.001).SignificanceOn-treatment CRP and HDL cholesterol levels are associated with CIMT among hypercholesterolemic patients under statin therapy. In patients receiving both statin and anti-hypertensive therapy, HDL cholesterol remains the main covariate of CIMT.