C-Reactive Protein Is a Better Predictor of Heart Problems Than Cholesterol

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Levels of C-reactive protein (CRP), a protein produced by the liver that is present only during episodes of inflammation, better predict the risk of having a cardiovascular event than levels of LDL (“bad”) cholesterol.

Researchers in Boston measured blood levels of CRP and LDL in 27,939 women who appeared to be healthy at baseline and then followed them for eight years, focusing on the number of cardiovascular events, strokes and deaths from cardiovascular causes. They found that women whose CRP levels were in the top 20 percent were 2.3 times more likely to have a cardiovascular event than those whose CRP was in the lowest 20 percent. Women whose LDL levels were in the top 20 percent were 1.5 times more likely to have a cardiovascular problem.

Some 77 percent of cardiovascular events occurred in women whose LDL levels were less than 160 mg/dl, and 47 percent occurred in those whose LDL levels were less than 130 mg/dl. The American Heart Association says that LDL levels below 100 mg/dl are “optimal,” while levels are not considered “high” unless they are over 160 mg/dl.

Researchers conclude that, since CRP and LDL cholesterol levels tended to identify different high-risk groups, screening for both CRP and LDL better predicts future health status than screening for either alone.

New England Journal of Medicine, November 14, 2002

Editor’s note: For more information about CRP, see “A New Buzzword,” page 66, in our November 2002 issue.

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