Cell adhesion molecules and incident hypertension in black and white adults: the REGARDS study.

Background: Higher C-reactive protein-quantified inflammation associates with greater incident hypertension risk. E-selectin, intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) are cell adhesion molecules that aid leukocyte adhesion during inflammation. Their association with incident hypertension is unclear.

Methods: REGARDS enrolled 30 239 Black and White US adults aged ≥45 years from across the contiguous United States in 2003-2007, with a second exam in 2013-2016. The Biomarkers as Mediators of Racial Disparities in Risk Factors (BioMedioR) study included 4400 REGARDS participants who attended both exams. We excluded participants with hypertension or missing biomarkers at baseline. Hypertension used a 140/90 mmHg threshold or self-reported use of blood pressure (BP) lowering medications. Modified Poisson regression estimated relative risk (RR) of incident hypertension by tertile of baseline E-Selectin, ICAM-1, and VCAM-1.

Results: Among 1879 nonhypertensive participants (mean [SD] age 62 [8] years, 25% Black race, 55% women) with 9 years median follow up, 36% developed hypertension. E-selectin and ICAM-1 were higher among Black participants; VCAM-1 was higher among White participants. Higher E-selectin was associated with greater risk of incident hypertension among White but not Black adults in some models (e.g., minimally adjusted: RR 1.27; 95% confidence interval (CI) 1.04-1.44 comparing tertile 3 vs. 1) ICAM-1 was associated with greater hypertension risk in only an unadjusted model.

Conclusion: In a prospective study of Black and White US adults, E-selectin was associated with incident hypertension among White adults and ICAM-1 in White and Black adults in partially or unadjusted models. Modification of E-selectin might be tested to lower risk of hypertension development.