So, CRP doesn't cause heart disease. I never thought it did.
Much has been made this week about some new studies showing that C-reactive protein, a compound that signals systemic inflammation, does not cause heart disease. See this description of the research from CNN (Study suggests C-reactive protein doesn't cause heart disease) and this reaction from the LA TImes: If C-Reactive protein isn't a cause of heart disease, what is?
Frankly, I'm not sure what the fuss is all about. The media is acting as if the link between inflammation and heart disease has been thrown into question. It hasn't.
C-reactive protein is one of several markers for systemic inflammation. Elevated CRP levels indicate an increased risk for heart disease--and many other diseases as well. While I guess it was important to make sure one way or the other, I, for one, never thought that CRP itself caused heart disease or arterial damage. It simply signals that inflammation is present.
A Declaration of Independence?
Many have questioned whether CRP is an independent risk factor. In other words, does measuring CRP levels really tell us anything that we don't already know from other screening tests?
I think it does. The other gold standard for assessing heart disease risk (cholesterol) is notoriously flawed. Measuring both CRP and cholesterol gives a more complete and nuanced picture. Monitoring CRP can also be a valuable way to monitor the effectiveness of treatment, especially lifestyle and diet interventions.
CRP screening is relatively inexpensive (around $60) and no more invasive than a standard cholesterol test. Plus, as this recent study points out, elevated CRP levels can help identify who is at highest risk for fatal (as opposed to non-fatal) heart attacks and might help us pinpoint those who would benefit from more aggressive treatment regimens.
Tell me something I don't know
For me the big unanswered question about CRP and disease risk is not whether the protein itself causes damage (which it apparently does not). What I'm waiting with bated breath to see is whether lowering elevated CRP with diet and lifestyle (as opposed to pharmaceuticals such as statin drugs) lowers the risk of disease.
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Posted by: darya | Jul 7, 2009 4:07:05 PM
Ha ha, I saw those stories and ignored them because they seemed irrelevant. Glad we agree :)
Posted by: Elite Health | Jul 6, 2009 12:57:49 AM
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Posted by: Andreson | Jul 4, 2009 7:40:36 AM
These results suggest that CRP should be taken into account when deciding whether to prescribe statins to a patients, a move that would result in millions more Americans taking the drugs.But the results of this new genetic study suggest that lower CRP doesn’t necessarily translate into a lower heart disease risk microsoft test. These findings support skeptics of the JUPITER trial, who argued that the improvements in cardiovascular disease risk seen with rosuvastatin treatment could have been due solely to their reduction (50%) of the study participants’ already low cholesterol levels.
Posted by: Brad F | Jul 3, 2009 5:26:50 AM
"Measuring both CRP and cholesterol gives a more complete and nuanced picture."
Same issue of JAMA, second study: Adding CRP to conventional risk scores ADDS LITTLE to risk reclassification. Above statement not entirely correct.
Monica's Response: The second study found that CRP adds little to risk classification in a LOW-RISK population. The predictive benefit in moderate risk individuals was "significant."
For example, CRP can help identify people with normal cholesterol who are nonetheless at risk. Also, there's the study I cited above, which shows that CRP adds information about how likely a heart attack is to be fatal. I think that's worthwhile.
Posted by: Prozac | Jul 3, 2009 3:42:45 AM
That is, in its own way, comforting to know for sure. What could CPR levels be a risk factor of, though? http://www.prozac.bz
