Issue 132 Item 13 C-Reactive Protein Continues to Make News: New Test of Heart H

The C-reactive protein (CRP) level is a stronger predictor of first cardiovascular events than is the LDL cholesterol level, according to a report in the November 14th issue of The New England Journal of Medicine. Previous studies have shown increased levels of CRP, a marker of inflammation, to be associated with an increased risk of myocardial infarction, stroke, sudden cardiac death, and peripheral artery disease, the authors explain. Few prospective studies, though, have compared the predictive value of CRP level with that of LDL cholesterol level.

Dr. Paul Ridker, from Brigham and Women’s Hospital and Harvard Medical School in Boston, and colleagues compared the predictive power of CRP level and LDL cholesterol level in all 27,939 participants in the Women’s Health Study who were followed for a mean of 8 years

Women with a high level of C-reactive protein, an index of inflammation, are twice as likely to have a heart attack or stroke as women with high cholesterol. This story, which is on the front page of many newspapers last week, may seem like a shot from the blue. Well, it is not. About half of the people with heart disease have normal cholesterol levels, which means there must be other factors capable of taking the lead role in cardiovascular disease. Inflammation has long been a candidate for this role.

There is a temptation to oversimplify health matters. In diabetes, for example, we have been fixated on the blood sugar although diabetes is clearly a complex disease that goes well beyond the blood sugar. So it has been with heart disease and stroke. We’ve been fixated on the cholesterol because it can be easily measured and the amount can go on the label of a product in the supermarket. There is more, much more, to heart disease and stroke. C-reactive protein better than LDL cholesterol in predicting first cardiovascular events