Plasma fibrinogen and incident hypertension in the Atherosclerosis Risk inCommunities (ARIC) study

Background Several cross-sectional studies have reported a positive associa tion between plasma fibrinogen levels and prevalent hypertension. Other stu dies have reported a positive association between hypertension and whole-bl ood or plasma viscosity, to which fibrinogen contributes. To our knowledge, there has been no prospective study of fibrinogen and incident hypertensio n. Subjects and methods We measured plasma fibrinogen levels in a population-b ased cohort study of middle-aged adults and related it to the occurrence of incident hypertension (systolic blood pressure greater than or equal to 14 0 mmHg or diastolic blood pressure greater than or equal to 90 mmHg or use of antihypertensive medication) over 6 years. Results There was a moderately strong positive association between fibrinog en levels and prevalent hypertension in both men and women, with the odds o f hypertension elevated by 50% for the highest fibrinogen quartile versus t he lowest Among 7884 participants at risk, 1609 developed hypertension over 6 years. Adjusted for age, race, field center and baseline systolic blood pressure, the odds ratio of incident hypertension in relation to fibrinogen quartiles was 1.0, 1.07, 1.21 and 1.43 in men (P=0.003 for trend) and 1.0, 0.92, 0.99 and 0.99 in women (P=0.89 for trend). After adjustment for othe r risk factors, the odds ratios were 1.0, 1.03, 1.15 and 1.29 (P=0.045 for trend) in men and remained nonsignificant in women. Conclusions Despite a moderately strong positive association between fibrin ogen levels and prevalent hypertension in both sexes, there was only a weak positive association between fibrinogen levels and incident hypertension i n men and no association in women. Whether an elevated fibrinogen level is a risk factor for, or a consequence of, hypertension remains unclear. J Hyp ertens 1998, 16:1579-1583 (C) Lippincott Williams & Wilkins.