Inflammation Worse Than Cholesterol For Heart

Study Looks At Protein Levels To Determine Heart Risks

BOSTON -- A new heart disease detection tool will awaken millions of people who thought they were not at risk, but will soon learn they are, according to a new study.

Researchers at Brigham and Women's Hospital studied more than 27,000 women and found that heart inflammation is the most powerful trigger of heart attacks.

The Women's Health Study found that testing for high levels of C-reactive protein, a blood marker for inflammation, better predicts heart disease than LDL, or bad cholesterol.

The finding, published in the Nov. 14 issue of the New England Journal of Medicine, is changing national health guidelines.

"It's almost 10 times the size of the Framingham Heart Study in terms of total women involved, and it shows very strongly -- overwhelmingly, in fact -- that the CRP levels are picking up more risk than are the LDL levels," Dr. Paul Ridker said.

The simple, $10 CRP blood test is widely available, but not often used.

Ridker estimates 25 percent of us have elevated levels of CRP -- but normal to low cholesterol, which means millions may unknowingly be at increased risk for future heart problems.

"CRP could help us determine high risk in someone that looks like they should be at low risk. When I see a 45-year-old man coming in with a heart attack in the middle of the night who doesn't have significant risk factors, those patients often have elevated CRPs," Dr. Richard Nesto said.

Nesto said that when identified, high CRPs can be effectively treated with cholesterol-lowering drugs, but many are missing out.

"It's an inescapable fact to me that there's a link between inflammation and heart attack and stroke, and CRP is how we measure that," Nesto said.

On Wednesday, the American Heart Association announced that along with the Centers for Disease Control and Prevention, it will issue new recommendations on CRP screening and hold a special session on CRP testing Nov. 17.

Ridker said that the combination of cholesterol and CRP results will help patients know their true heart disease risk.

"They both really matter. We still want to lower our patients' cholesterol levels, but now we have to take into account an entire new biology to understand this disease," Ridker said.

American Heart Association Response

Additional Resource:

• Article in the New England Journal of Medicine

Previous Stories:

• October 16, 2002: Birth Control Shot Tied To Heart Risk
• September 24, 2002: Teen Hormone Linked To Heart Disease
• September 18, 2002: Beware Of High Triglyceride Levels
• September 16, 2002: Heart Disease Gene Linked To Prostate Cancer
• July 25, 2002: Golfing Can Work The Heart Too Hard
• July 17, 2002: Heart Attack, Stroke Prevention Guidelines Updated
• July 2, 2002: Hormone Therapy Doesn't Protect Heart
• June 25, 2002: FDA Approves Skin Cholesterol Test
• June 25, 2002: Pitcher's Death Sparks Fear Of Heart Disease
• June 20, 2002: Estrogen Protects Heart By Hindering Inflammation
• June 14, 2002: More Children At Risk Of Heart Disease
• May 24, 2002: Lonely People At Risk For Heart Disease
• May 22, 2002: Overeating Can Raise Risk Of Heart Attack

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