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(Circulation. 2006;114:2034-2039.)
© 2006 American Heart Association, Inc.

Hypertension

Creatine Kinase Activity Is Associated With Blood Pressure

Lizzy M. Brewster, MD; Gideon Mairuhu, MD; Navin R. Bindraban, MD; Richard P. Koopmans, MD, PhD; Joseph F. Clark, PhD; Gert A. van Montfrans, MD, PhD

From the Departments of Internal Medicine (L.M.B., G.M., R.P.K., G.A.v.M.) and Social Medicine (N.R.B.), Academic Medical Center, Amsterdam, the Netherlands, and Department of Neurology (J.F.C.), University of Cincinnati, Cincinnati, Ohio.

Correspondence to Lizzy M. Brewster, MD, Department of Internal Medicine, F4-222, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. E-mail mail{at}lizzybrewster.net

Received August 30, 2005; revision received August 30, 2006; accepted September 8, 2006.

Background— We previously hypothesized that high activity of creatine kinase, the central regulatory enzyme of energy metabolism, facilitates the development of high blood pressure. Creatine kinase rapidly provides adenosine triphosphate to highly energy-demanding processes, including cardiovascular contraction, and antagonizes nitric oxide–mediated functions. Relatively high activity of the enzyme, particularly in resistance arteries, is thought to enhance pressor responses and increase blood pressure. Tissue creatine kinase activity is reported to be high in black people, a population subgroup with greater hypertension risk; the proposed effects of high creatine kinase activity, however, are not "race dependent." We therefore assessed whether creatine kinase is associated with blood pressure in a multiethnic population.

Methods and Results— We analyzed a stratified random sample of the population of Amsterdam, the Netherlands, consisting of 1444 citizens (503 white European, 292 South Asian, 580 black, and 69 of other ethnicity) aged 34 to 60 years. We used linear regression analysis to investigate the association between blood pressure and normal serum creatine kinase after rest, as a substitute measure of tissue activity. Creatine kinase was independently associated with blood pressure, with an increase in systolic and diastolic pressure, respectively, of 8.0 (95% CI, 3.3 to 12.7) and 4.7 (95% CI, 1.9 to 7.5) mm Hg per log creatine kinase increase after adjustment for age, sex, body mass index, and ethnicity.

Conclusions— Creatine kinase is associated with blood pressure. Further studies are needed to explore the nature of this association, including how variation in cardiovascular creatine kinase activity may affect pressor responses.

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