By: Jean Johnson for Heart1
Say the word heart attack or stroke and everyone pays attention. Thus even as the population puts on more weight and languishes on couches in front of TVs, Americans have worked hard to keep their cholesterol levels in tow.
The latest research published in the New England Journal of Medicine, however, shows that simply managing cholesterol isn’t enough. Data from almost 28,000 women followed for eight years shows that the C-reactive protein (CRP) level is a stronger predictor of heart disease and stroke than LDL cholesterol, or low density lipid or the “bad” kind of cholesterol.
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How Does a C-Reactive Protein Test Work?
To test the CRP level, blood is drawn from a vein. The collected blood is then tested to determine the levels of protein and protein-bound molecules. The noted CRP level can then be used as a predictor for conditions including heart disease and stroke.
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Gary Thorgaard manages his risk for heart disease with cholesterol-lowering drugs. Sitting in his office at Washington State University with stacks of thick scientific reports balanced on every available space, the geneticist and professor of biological sciences is restrained about the latest news.
“It’s good that they’re getting more information about better predictors. But exercise and eating right – not that I’m necessarily doing as well as I should,” Thorgaard said, laughing, “seems to be the key in controlling Americans’ predisposition to heart disease.”
Thorgaard wears a brown tweed sweater against eastern Washington’s 20 degree temperatures and his light brown hair is thinning on the top of his head. “I’d be interested in having the test done if it’s available and not too expensive and my doctor recommended it,” he said. “Still, part of how our healthcare system gets to be so expensive is because everyone, myself included, wants to have the best possible tests.”
CRP increases during low-grade systemic inflammation, a process scientists believe is important in atherosclerosis, or the build up of fatty deposits in the lining of the arteries. Causes of inflammation are largely unknown, although new findings point to chronic types of infection arising from bacteria or virus as a potential source.
Most physicians appreciate the idea that chronic infection can lead to other diseases. And in the case of stomach ulcers, for example, routine treatment includes antibiotic therapy for the bacterial infection Helicobacter pylori.
H. pylori is also suspected in systemic inflammation of the arteries and elevated CRP levels along with Chlamydia pneumoniae. Possible viral agents include herpes simplex virus and cytomegalovirus. People with autoimmune diseases like lupus and cancer also often have high CRP levels.
While in a Jan. 11 editorial, The New York Times was quick to cite CRP studies as indicators of revolutionary shift in the understanding of heart disease, physicians remain more skeptical of the early data. Questions have arisen about how abnormal levels of CRP should be treated as well as how the instance of CRP figures into assessments of overall risk. More, some fear that routine screening for CRP could lead to unwarranted treatment regimes.
