It May Not Be Enough to Reduce Bad Cholesterol to prevent Heart Attacks
Inflammation is the process whereby the body responds to injury. Recent studies by the Brigham and Women’s Hospital and the Cleveland Clinic suggest that inflammation is important in the process in which fatty deposits build up in the lining of arteries, a leading cause of heart attacks. C-reactive protein (CRP) is an inflammatory marker-a substance that the body releases in response to inflammation. High levels of CRP in the blood mean that there is inflammation somewhere in the body. CRP levels rise due to heart attack, stroke and other cardiovascular events. The studies which appeared in a recent issue of the New England Journal of Medicine suggest that testing CRP levels in the blood may be a new way to assess cardiovascular disease risk.
CRP testing may indicate the severity of cardiovascular disease, and the effectiveness of the treatment. It may also help evaluate the risk of a second heart attack or stroke or complications following some cardiac procedure. The study by the Brigham and Women’s Hospital showed that patients with the lowest risk of suffering a second heart attack also had the lowest levels of CRP. The Cleveland Clinic study found that 502 patients, who lowered their CRP levels the most, evidenced some unclogging of the arteries.
Because CRP levels are not specific to any one area of the body, it does not preclude the testing of cholesterol, blood pressure and other risk factors in predicting cardiovascular disease in healthy people. Cholesterol and CRP levels are independent of each other and therefore, one blood test isn’t enough. The type of inflammation contributing to heart disease is different from the form treated with aspirin and other related drugs. CRP measures that inflammation. Fortunately, it appears that statins—the type of drugs that have been prescribed to reduce “bad” cholesterol, also brings down CRP levels.
Should you be tested for CRP? Experts are debating whether physicians should routinely measure CRP levels in healthy patients. CRP levels can rise in response to many illnesses and chronic diseases, including bronchitis, diabetes, and in response to physical trauma. However, most agree that CRP levels can be very useful measurements in people already diagnosed or at high risk for cardiovascular disease (high levels of “bad” cholesterol, high blood pressure, family history of heart disease, smokers, overweight). For these people a CRP test can help predict a cardiovascular and/or stroke event and help direct further evaluation and therapy.
What is the normal range of CRP? Levels lower than 1.0 mg/l (milligram per liter) represent low risk of developing cardiovascular disease and levels between 1.0 and 3.0 mg/l, average risk. If the CRP level is higher than 3.0 mg/l a person is at high risk. If a patient persistently tests at high levels of CRP, other evaluations and tests should be considered to exclude non cardiovascular causes.
The studies conclude that while CRP testing alone cannot be considered a definitive tool in predicting heart attacks or stroke, when combined with other tests it has the potential to save thousands of lives and change the way the public thinks about heart disease prevention.
For more information:
American Heart Association http://www.americanheart.org
Heart Center Online Heart Health