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Comparison of C-reactive Protein and LDL Cholesterol Levels

 

(American Heart Association) 14/11/2002

In a group of more than 27,000 women participating in the ongoing Women's Health Study, elevated levels of C-reactive protein (CRP), a blood-marker for inflammation, was a better predictor of risk for future cardiovascular (CVD) events than elevated low-density lipoprotein (LDL) cholesterol levels. The researchers note that a combined evaluation of CRP and LDL may be a superior method of risk detection because they appear to complement each other. They caution, however, that more data needs to be collected on CRP before these results can be translated into clinical practice.

"We believe CRP measurement should be seriously evaluated as part of a strategy in assessing an individual's global cardiovascular disease risk," says Robert O. Bonow M.D., president of the American Heart Association. Global risk estimation combines information from all existing risk factors, such as elevated LDL, high blood pressure and smoking status, to determine a person's overall risk for developing cardiovascular disease in the next ten years.

"The American Heart Association and the Centers for Disease Control and Prevention will be issuing a joint report within the next several months that will include recommendations on CRP screening," says Bonow. In developing these recommendations, the role of CRP in clinical practice will be the focus of a special session on Sunday, November 17 during the American Heart Association's 75th annual Scientific Sessions in Chicago.

"As the study authors note, many individuals who have a cardiovascular event, such as a heart attack, have LDL cholesterol levels below 130 milligrams per deciliter, which means they may not have met criteria for lowering LDL with medications prior to their heart attack. However, a large-scale clinical trial should be able to determine if individuals with low LDL but elevated CRP may ultimately be good candidates for medical therapy with statin drugs, because these cholesterol-lowering drugs also seem to lower CRP levels," Bonow says.

"These results from the Women's Health Study also give credence to the growing body of evidence suggesting that atherosclerosis is an inflammatory process," he says.
Inflammation is the body's response to injury, and is believed to be a key component of atherosclerosis, the disease process that causes fatty deposits to build up in the lining of arteries.

The causes for the low-grade inflammation that may increase the risk of cardiovascular disease are uncertain, but experts hypothesize that a bacterial or viral infection might contribute to or cause atherosclerosis. Additionally, it is still not certain whether the CRP elevations are a result of atherosclerosis, rather than a marker for a causative agent, such as a bacteria or virus.
Determining the association between CRP and CVD risk is important, because it may lead to better treatments for preventing heart attack and stroke.

(c) 2002 Sociedad Española de Medicina Antienvejecimiento y Longevidad

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