New data from the ongoing Women’s Health Study shows elevated levels of a blood-marker for inflammation called C-reactive protein (CRP) was a better predictor of risk for future cardiovascular events such as heart attack and stroke, than elevated levels of low-density lipoprotein (LDL) cholesterol.
“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. “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 said.
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.
“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 said.
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.
Determining the association between CRP and cardiovascular disease risk is important, because it may lead to better treatments for preventing heart attack and stroke.