Serum furin as a biomarker of high blood pressure: findings from a longitudinal study in Chinese adults.

The cardiovascular protective role of furin has been suggested by some animal-based studies but has not been well studied in humans. Therefore, the objective of this study was to examine the prospective association between serum furin and high blood pressure in a longitudinal cohort of Chinese adults. Leveraging a longitudinal prospective cohort with blood pressure examined twice on average 4 years apart, we systemically examined the cross-sectional, longitudinal, and prospective associations of baseline serum furin with blood pressure and incident hypertension. Conventional risk factors, including age, sex, education level, cigarette smoking, alcohol consumption, BMI, fasting glucose, and lipids, were controlled. All participants included were free of cardiovascular and kidney disease at baseline. The cross-sectional analysis of 2312 participants (mean age 53 years) revealed that individuals with the lowest quartile of serum furin had average systolic, diastolic, and mean arterial blood pressures that were 2.58, 1.38, and 1.61 mmHg higher, respectively, than the corresponding pressures in individuals with the highest quartile (all P < 0.001). These negative associations remained significant after controlling for the dynamic risk profiles during follow-up in the longitudinal analysis. The prospective analysis of 1088 participants free of prevalent hypertension at baseline revealed that compared with participants with the highest quartile of serum furin, those with the lowest quartile had a 46% increased risk of incident hypertension (HR = 1.46, P = 0.003). These results indicate that lower serum furin is significantly associated with higher blood pressure and predicts an increased future risk of developing hypertension in Chinese adults. Furin may be a protective factor or marker of hypertension.