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Creatine Kinase and Blood Pressure: A Systematic Review

1
Creatine Kinase Foundation, POB 23639, 1100 EC Amsterdam, the Netherlands
2
Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
3
Department of Internal Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
*
Author to whom correspondence should be addressed.
Med. Sci. 2019, 7(4), 58; https://doi.org/10.3390/medsci7040058
Received: 15 February 2019 / Revised: 25 March 2019 / Accepted: 29 March 2019 / Published: 9 April 2019
(This article belongs to the Section Cardiovascular Disease)
Background: Hypertension is a main risk factor for premature death. Although blood pressure is a complex trait, we have shown that the activity of the ATP-generating enzyme creatine kinase (CK) is a significant predictor of blood pressure and of failure of antihypertensive drug therapy in the general population. In this report, we systematically review the evidence on the association between this new risk factor CK and blood pressure outcomes. Method: We used a narrative synthesis approach and conducted a systematic search to include studies on non-pregnant adult humans that address the association between plasma CK and blood pressure outcomes. We searched electronic databases and performed a hand search without language restriction. We extracted data in duplo. The main outcome was the association between CK and blood pressure as continuous measures. Other outcomes included the association between CK and blood pressure categories (normotension and hypertension, subdivided in treated controlled, treated uncontrolled, and untreated hypertension). Results: We retrieved 139 reports and included 11 papers from 10 studies assessing CK in 34,578 participants, men and women, of African, Asian, and European ancestry, aged 18 to 87 years. In 9 reports, CK was associated with blood pressure levels, hypertension (vs. normotension), and/or treatment failure. The adjusted increase in systolic blood pressure (mmHg/log CK increase) was reported between 3.3 [1.4 to 5.2] and 8.0 [3.3 to 12.7] and the odds ratio of hypertension with high vs. low CK ranged between 1.2 and 3.9. In addition, CK was a strong predictor of treatment failure in the general population, with an adjusted odds ratio of 3.7 [1.2 to 10.9]. Discussion: This systematic review largely confirms earlier reports that CK is associated with blood pressure and failure of antihypertensive therapy. Further work is needed to address whether this new risk factor is useful in clinical medicine. View Full-Text
Keywords: creatine kinase; blood pressure; hypertension; systematic review; continental ancestry groups; antihypertensive drugs creatine kinase; blood pressure; hypertension; systematic review; continental ancestry groups; antihypertensive drugs
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Brewster, L.M.; Karamat, F.A.; van Montfrans, G.A. Creatine Kinase and Blood Pressure: A Systematic Review. Med. Sci. 2019, 7, 58.

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