In a nutshell
This study evaluated the association between high blood pressure (hypertension), diabetes mellitus, and C-reactive protein (a marker for inflammation) and coronary artery spasm.
Some background
A coronary artery spasm (CAS) is a sudden constriction, or narrowing, of one of the arteries that supply blood to the heart (coronary arteries), which slows or stops blood flow. While this is a temporary condition, over time it can lead to coronary artery disease or CAD (a progressive narrowing of the coronary arteries), which manifests as repetitive angina (chest pains). Patients with CAS often have elevated levels of C-reactive protein (CRP), a protein that increases when there is inflammation in the body. This indicates that CAS is an inflammatory condition. It is not clear, though, what role CRP plays in the development of the spasms. Hypertension can lead to impairment in the ability of blood vessels to widen (vasodilation), and it is a major risk factor for the development of CAD. Diabetes mellitus also impairs vasodilation and vasoconstriction (the ability of blood vessels to narrow). However, whether or not hypertension and/or diabetes are risk factors for CAS is unclear. The current study examines the roles hypertension, diabetes, and CRP play in the development of CAS.
Methods & findings
811 patients with symptoms of chest pain were included in this study. 489 of these patients were diagnosed with CAS and the remaining 322 did not have CAS and served as the comparison (control) group. Patients were followed up for an average period of 8 years and the main parameters measured were the association between gender, age, hypertension, diabetes mellitus, CRP and CAS.
Results showed that men, elderly patients and smokers had a higher risk of developing CAS. Also, high levels of CRP (more than 3 mg/L) were associated with higher rates of CAS than were low levels. However, hypertensive women with high CRP had a 7-fold risk reduction in developing CAS, while men had only a 0.25 risk reduction. Similarly, high CRP levels in women with diabetes mellitus were associated with a 3-fold decrease in their risk of developing CAS, while in men there was a 1.5-fold risk reduction. Also, women with both diabetes and hypertension who had high CRP levels had a higher risk of developing CAS, but this effect was not seen in men.
The bottom line
This study concluded that high CRP levels independently predict CAS development. Hypertension alone seemed to have a protective effect in developing CAS in women with high CRP levels. However, the presence of hypertension in women with diabetes mellitus had a more negative effect in the development of CAS compared to non-diabetic women, but this effect was not seen in men.
The fine print
This study was based on information from hospital registry and is of observational nature. Therefore it cannot accurately prove a causal relationship between the parameters measured. Also, there were no measurements of male and female sex hormones to determine whether the gender differences observed are due to hormonal effects. Further studies are needed to better understand this association.
Published By :
PLOS ONE
Date :
Oct 28, 2013
Corrected typo. I have coronary spasms and mine cause hypertensive events. When I go into spams my blood pressure with rise rapidly to at time anywhere from 180/105 to 220/144. The Coronary spams themselves cause a very quick increase in blood pressure.
Are you a man? This study shows that hypertension is negative for women but not negative for men in developing coronary spasm. Furthermore, is your high-sensitivity C-reactive proetin high? Do you have diabetes? How old are you? Please take all these factors into account before you conclude. From the medical literature, so far, coronary spasm is a multifactorial disease.