White blood cell count, C-reactive protein, and incident heart failure in the Atherosclerosis Risk in Communities (ARIC) Study.

PURPOSE: To test the hypothesis that inflammation measured by white blood cell count (WBC) and C-reactive protein (CRP) is associated positively with incident heart failure (HF).

METHODS: Using the Atherosclerosis Risk in Communities (ARIC) Study, we conducted separate Cox proportional hazards regression analyses for WBC (measured 1987-1989) and CRP (measured 1996-1998) in relation to subsequent heart failure occurrence. A total of 14,485 and 9,978 individuals were included in the WBC and CRP analyses, respectively.

RESULTS: There were 1647 participants that developed HF during follow-up after WBC assessment and 613 developed HF after CRP assessment. After adjustment for demographic variables and traditional HF risk factors, the hazard ratio (95% confidence interval) for incident HF across quintiles of WBC was 1.0, 1.10 (0.9-1.34), 1.27 (1.05-1.53), 1.44 (1.19-1.74), and 1.62 (1.34-1.96), p trend

CONCLUSIONS: Greater levels of WBC (especially granulocytes) and CRP are associated with increased risk of heart failure in middle-aged adults, independent of traditional risk factors.