Cardiovascular Disease: Not determined by Lipid Assays Only

posted by DRveejay

Cardiovascular Disease: Not determined by Lipid Assays Only

C-Reactive Protein's Role in Cardiovascular Disease

Recent research suggests that patients with elevated basal levels of CRP (C-reactive protein) are at an increased risk for hypertension and cardiovascular disease, although recent research suggests the correlation is moderate.

The amount of CRP produced by the body varies from person to person, and this is affected by lifestyle as well as genetic makeup, which accounts for almost half of the variation in CRP levels between different people. Higher CRP levels tend to be found in smokers and in people who are sedentary, overweight or who have high blood pressure. Lean, athletic individuals tend to have lower CRP levels.

Research shows that too much inflammation can sometimes have adverse effects on the blood vessels which transport oxygen and nutrients throughout our bodies. Atherosclerosis, which involves the formation of fatty deposits or plaques in the inner walls of the arteries, is now considered in many ways an inflammatory disorder of the blood vessels, similar to how arthritis is an inflammatory disorder of the bones and joints. Inflammation not only affects the atherosclerotic phase of heart disease, but also the rupturing of plaques which can then travel and interfere with blood flow, causing a heart attack.

Many studies have shown an association between elevated levels of inflammatory markers (including CRP) and the future development of heart disease. This is true even for apparently healthy men and women who have normal cholesterol levels. The reason CRP can be used by physicians as part of the assessment of a patient's risk for heart disease is because it is a stable molecule and can be easily measured with a simple blood test. In patients already suffering from heart disease, doctors can use CRP levels to determine which patients are at high risk for recurring coronary events.

To measure the CRP level, a "high-sensitivity" CRP or hs-CRP test needs to be performed and analyzed by a laboratory. This is an automated blood test designed for greater accuracy in measuring low levels of CRP, which allows the physician to assess cardiovascular risk. If a result in the low-risk range is found ( < 1 mg/L), it does not need repeating. Higher levels need repeating, and clinical evaluation as necessary.

Studies have suggested that CRP may also be elevated in heart attacks. The role of CRP in coronary artery disease remains unclear. It is not known whether it is merely a marker of disease or whether it actually plays a role in causing atherosclerotic disease. Many consider elevated CRP to be a positive risk factor for coronary artery disease.