Predicting Women's Heart Problems

Nov. 14, 2002 (Ivanhoe Newswire) -- Twenty years ago, 246 risk factors for coronary heart disease were identified, and that list continues to grow. Researchers from Brigham and Women's Hospital and Harvard Medical School say the C-reactive protein level may be another predictor of future cardiovascular problems, but not everyone agrees.

In response to acute injury, infection, or other inflammatory stimuli, the body releases C-reactive protein (CRP). Studies have shown a positive association between CRP and coronary artery disease. In the current study, researchers looked at CRP and LDL, or "bad" cholesterol levels as a predictor for future heart problems in women.

The study included 27,939 healthy American women who were followed for eight years. Researchers recorded heart attacks, strokes, or deaths from cardiovascular causes. At the beginning of the study, the women's CRP and LDL cholesterol was noted. Researchers used these measurements to determine if they were associated with future heart health problems.

Researchers adjusted for age, smoking status, diabetes, levels of blood pressure, and hormone replacement therapy. After making these adjustments, they found women with higher CRP levels were more likely to have a coronary event. According to the American Heart Association, an optimal LDL level is below 100. An LDL level between 100 and 129 is near or above optimal, while a level between 130 and 159 is considered "borderline high." Seventy-seven percent of the health problems occurred among women with LDL cholesterol levels below 160 mg per deciliter, and 46 percent of the health problems occurred among women with an LDL cholesterol level below 130 mg per deciliter. Researches say CRP and LDL cholesterol measurements identified different high-risk groups, however they say CRP is a stronger predictor of cardiovascular events than LDL cholesterol level.

In an accompanying editorial, Lori Mosca, M.D., Ph. D., from Columbia University in New York agrees there is evidence to support an association of higher levels of CRP with an increased risk of cardiovascular disease. However, Dr. Mosca writes, "The predictive power of this association is markedly diminished when adjusted for other risk factors. Any clinical significance of the added value of C-reactive protein over conventional markers of coronary heart disease is debatable."

SOURCE: The New England Journal of Medicine, 2002;347:1557-1564 and 1615-1616

[Cardiovascular Health Home]