Creatine Kinase and New-Onset Hypertension: A 10-Year Follow-Up Study

BACKGROUND: Creatine kinase (CK), the enzyme that rapidly regenerates ATP for cardiovascular pressor responses, has been associated with hypertension in experimental settings and cross-sectional population studies, but the temporal relationship between CK and new-onset hypertension remains understudied. METHODS: We included 515 adults (42% men, mean age 45.6 years, SE 0.2) who participated in population studies with baseline and 10-year follow-up cardiovascular measurements. The primary outcome was the association between baseline resting plasma CK and the development of new-onset hypertension (systolic blood pressure ≥140, diastolic ≥90 mm Hg, or receiving antihypertensive drugs at 10 years, in persons without hypertension at baseline). We adjusted the outcome for cardiovascular risk factors, including sex, age, and body mass index (BMI), in multivariable logistic regression analysis. RESULTS: Among individuals without hypertension at baseline (n = 362), systolic/diastolic blood pressure (mean, SE), increased over 10 years by +14.2 (0.7)/+4.6 (0.8), rising from 117.1 (0.6)/76.4 (0.4) to 131.1 (0.8)/81.0 (0.5) mm Hg. Baseline CK was higher in participants with new-onset hypertension (n = 143, 40%) than in those without hypertension at follow-up, respectively 148.0 (SE 7.1) vs. 120.2 (5.1) IU/L. New-onset hypertension was independently associated with age (years), odds ratio (95% CI) 1.07 (1.03-1.11); BMI (kg/m2), 1.09 (1.03-1.15); and baseline CK, 6.05 (2.33-15.70)/logCK. CONCLUSIONS: High CK levels precede hypertension, suggesting a causal link and a potential new target for antihypertensive therapy. CK estimations could help identify individuals for intensified blood pressure monitoring and preventive cardiovascular risk management.