C-Reactive Protein Levels Point to Cardiovascular Risk

High levels of C-reactive protein are associated with the risk of coronary heart disease, even after carefully adjusting for other known risk factors.

"Few studies have simultaneously investigated the role of soluble tumor necrosis factor-alpha receptors types 1 and 2 (sTNF-R1 and sTNF-R2), C-reactive protein, and interleukin-6 as predictors of cardiovascular events," senior author Dr. Eric B. Rimm, at the Harvard School of Public Health in Boston, and colleagues explain.

They conducted their nested case-control analyses using data from the Nurses’ Health Study, which included women (n=121,700) ages 30 to 55 years in 1976, and the Health Professionals Follow-up Study, which involved men (n=51,529) ages 40 to 75 in 1986.

Among subjects free of cardiovascular disease at baseline, 239 women and 265 men had an MI or fatal coronary heart disease during 6 to 8 years of follow-up. Dr. Rimm’s group selected 469 women and 529 men as controls, matched for age and smoking status.

Blood samples at baseline showed that patients had significantly higher baseline levels of interleukin-6 and C-reactive protein than control subjects, after adjusting for age and smoking. Women also had significantly higher levels of the two TNF receptors.
After further adjustment for lipid levels, family history, alcohol intake, physical activity, BMI, diabetes, hypertension, and hormone therapy, only C-reactive protein remained significant, with levels 3.0 mg/L or higher posing a relative risk of 1.68 compared with levels < 1.0 mg/L.

"The question remains, whether physicians should be measuring C-reactive protein in patients," lead author Dr. Jennifer K. Pai told Reuters Health. "We think this is particularly important, now that questions are arising whether or not statins act through another mechanism in addition to lowering lipid levels, if they are also lowering inflammatory profiles."

She added: "Although C-reactive protein is a strong risk marker, with the ability to predict risk beyond what we already know, we should emphasize that smoking cessation, physical activity, and eating a healthy diet will improve those levels. The first line of defense is still to encourage a healthy lifestyle."

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