Children's Hospital Boston | Children's News Online

02.14.03

New tool fights heart disease

eart disease is the number-one killer of adults in the Western world. Over a million Americans suffer heart attacks every year, and many who suffer these attacks have never had the symptoms of heart disease. But thanks to work done by Paul Ridker, MD, cardiologist at Brigham and Women’s Hospital, Nader Rifai, PhD, investigator in Laboratory Medicine, and their colleagues, a new screening tool offers a more effective way to assess heart attack risk than standard cholesterol and blood pressure tests alone.

The inexpensive blood-screening test measures levels of C-reactive protein (CRP), an indicator of inflammation in blood-vessel walls. In a study published in the January issue of Circulation, the researchers evaluated the relevance of CRP and found that elevated CRP levels were linked to increased risk of heart attack, stroke and type 2 (non-insulin dependent) diabetes.

The researchers examined CRP levels of nearly 15,000 participants in the ongoing Women’s Health Study, including almost 4,000 women who had “metabolic syndrome,” meaning they displayed at least three of five conditions (abdominal obesity, high triglycerides, low levels of “good” HDL cholesterol, high blood pressure and high blood sugar) associated with a significant cardiovascular risk.

After eight years of follow-up, subjects with metabolic syndrome and CRP levels above 3.0 milligrams per Liter (mg/L) had almost twice the rate of heart attacks, strokes, operations to restore blood flow to the heart and death from cardiovascular disease than those with metabolic syndrome and CRP levels of less than 3.0 mg/L.

“This work comes on the heels of other studies that indicate CRP is an accurate predictor of cardiovascular events,” says Rifai. “It demonstrates that CRP is not only a predictor of risk in healthy individuals, but also in those with metabolic syndrome.”

In response to the study, the American Heart Association and the Centers for Disease Control and Prevention have drawn up guidelines for physicians to use the test. The guidelines suggest that physicians use CRP levels when deciding the right treatment and prevention strategies for patients who already show heightened cardiovascular risk.

While studies haven’t yet found evidence that lowering CRP will lower cardiovascular risk, that possibility is a promising direction for future research. In the meantime, lifestyle changes such as a heart-healthy diet, regular exercise, weight loss and stopping smoking can reduce the risk of heart disease and diabetes. —CM