C Reactive Protein A To Z
This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA
Overview
Download & View C Reactive Protein A To Z as PDF for free.
More details
- Words: 2,643
- Pages: 11
What is C-Reactive Protein (CRP)? How Is C-Reactive Protein (CRP) Associated With the Risk of Cardiovascular Disease? How Is C-Reactive Protein (CRP) Related to the Risk of Hypertension? Why hs-CRP ? What Do the hs-CRP Test Results Mean? Why Is it Important to Have Both hs-CRP and Cholesterol Measured? Is hs-CRP the Only "Novel Risk Factor" for Heart Disease? What Role Does C-Reactive Protein (CRP) Play in Diabetes and the Metabolic Syndrome? Do Diabetes Treatments Affect Inflammation? Is C-Reactive Protein (CRP) Specifically Related To Cardiovascular Disease? At What Age Is CRP Testing Appropriate? How Can I Lower My C-Reactive Protein (CRP) Level? What Do Aspirin and the "Statin" Drugs Do? Do patients taking statin drugs need to have hs-CRP measured in follow-up? Which People Should Be Tested for hs-CRP? FAQ Answers What is C-Reactive Protein (CRP)?
Apr 07 back to top
C-reactive protein (CRP) is a molecule produced in response to inflammation, which occurs
when the body is exposed to a major trauma or infection. CRP is therefore a marker of inflammation. CRP is not only produced within the liver, but also appears to be produced in both visceral fat and within coronary vessels. It has recently been discovered that CRP also plays a role in heart disease.
The amount of CRP produced by the body varies from person to person, and this is affected by an individual's genetic makeup (accounting for almost half of the variation in CRP levels between different people) and lifestyle. Higher CRP levels tend to be found in individuals who smoke, have high blood pressure, are overweight and don't exercise, whereas 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.
Copyright © 2004 E-MedHosting.com Inc.
How Is C-Reactive Protein (CRP) Associated With the Risk of Cardiovascular Disease?
back to top
Several major studies have shown that C-Reactive Protein (CRP) levels in apparently healthy men and women are strongly predictive of the future risk of heart attack, stroke, sudden cardiac death as well as the development of peripheral arterial disease. In patients already suffering from heart disease, doctors can use CRP levels to determine which patients are at high risk for recurring coronary events. Since high levels of CRP are indicative of a 2-3 fold higher risk of cardiovascular disease, your doctor may want to measure your CRP level, perhaps at the same time as measuring your cholesterol level. Even after taking into account all other risk factors, those with elevated CRP levels have a risk 50-70 percent higher.
Copyright © 2004 E-MedHosting.com Inc. How Is C-Reactive Protein (CRP) Related to the Risk of Hypertension?
back to top
In the last decade or so several studies have suggested that hypertension or high blood pressure, is in part an inflammatory disorder. As early as 1997 it was found that the risk of having a future stroke went up with increasing levels of hs-CRP in apparently healthy men. This finding was confirmed in a large study of healthy women by 2002. Since hypertension is a major risk factor for the development of stroke, these outcomes suggested to doctors that inflammation (indicated by high hs-CRP levels) and hypertension may be working together to increase the chances of having a stroke.
In more recent major studies done in initially healthy women, those having a high hs-CRP level on top of high blood pressure were at much greater risk of having a future event such as a heart attack or stroke. Furthermore, the risk of developing hypertension in the future was greater in those individuals having higher hs-CRP levels, even in the presence of low blood
pressure in the beginning. These studies have prompted further research to find out more about the role of inflammation in hypertension.
The Val-MARC (Valsartan - Managing BP Aggressively and Evaluating Reductions in hsCRP) trial is currently investigating whether blood pressure reduction with Diovan (valsartan) will decrease hs-CRP levels and if the dose of medication used would influence any effect on hs-CRP levels. If you would like to learn more or may be interested in participating in this study, please call 1-888-526-4745 or go to http://www.valmarctrial.com on the Internet.
Copyright © 2004 E-MedHosting.com Inc. Why hs-CRP ?
back to top
To measure your C-Reactive Protein (CRP) level, your doctor will need to order the "highsensitivity" CRP or hs-CRP test from the laboratory. This is a simple blood test designed for greater accuracy in measuring CRP, which allows the physician to use the result in the assessment of cardiovascular risk.
Copyright © 2004 E-MedHosting.com Inc. What Do the hs-CRP Test Results Mean?
back to top
hs-CRP levels are expressed in terms of milligrams per liter (mg/L). Concerning your hs-CRP level and cardiovascular risk, a level of less than 1mg/L indicates lower risk, a level between 1 and 3mg/L indicates moderate risk, and a level higher than 3mg/L indicates a higher risk. As research has shown, this may hold true even if your LDL cholesterol levels are low.
If your hs-CRP level is very high, above 10mg/L, you should have the test repeated after 2-3 weeks, as the high hs-CRP level may reflect an acute infection that you are experiencing at the time. You should therefore have your hs-CRP evaluated only when feeling well. If upon repeat testing your hs-CRP level remains high, then you are most probably in the higher cardiovascular risk group.
In middle-aged Americans, the average hs-CRP level is between 1.0 and 2.0 mg/L. About one quarter of Americans have a hs-CRP level above 3mg/L, placing them in the higher risk group.
Copyright © 2004 E-MedHosting.com Inc. Why Is it Important to Have Both hs-CRP and Cholesterol Measured?
back to top
High hs-CRP and high LDL or "bad" cholesterol levels represent different pathways leading to heart disease. Therefore doing measurements of both of these provides the doctor with more information about your cardiovascular risk than measuring LDL cholesterol alone. Persons with high hs-CRP and high LDL cholesterol are at greatest risk and those with low hs-CRP and low LDL cholesterol are at lowest risk.
If your hs-CRP or LDL cholesterol levels are high, your doctor may advise you to adopt some lifestyle changes such as losing weight, stopping smoking, exercising and following a recommended diet, all of which will lower your cardiovascular risk as well as hs-CRP levels. There are also some medications you may wish to consider.
Copyright © 2004 E-MedHosting.com Inc.
Is hs-CRP the Only "Novel Risk Factor" for Heart Disease?
back to top
Besides C-Reactive Protein (CRP), there are other novel risk factors for heart disease such as homosysteine and lipoprotein(a), among others. hs-CRP however is the inflammatory marker with the strongest predictive value for future cardiovascular events, and has been shown to add prognostic information to that obtained from cholesterol screening. In the future, it is possible that other markers of inflammation beyond CRP will be introduced.
Copyright © 2004 E-MedHosting.com Inc. What Role Does C-Reactive Protein (CRP) Play in Diabetes and the Metabolic Syndrome?
back to top
High hs-CRP levels also predict increased risk of developing type 2 diabetes. In some patients, this increased inflammation comes from obesity, as fat cells secrete proteins which stimulate the production of C-Reactive Protein (CRP).
Patients with the metabolic syndrome have an increased chance of developing heart disease and diabetes. Individuals are currently classified as having the metabolic sydrome if they meet 3 of the following 5 criteria: low HDL or "good" cholesterol, obesity, high triglycerides, increased blood sugar levels or high blood pressure. These however don't represent all the components or contributing factors in the metabolic syndrome. CRP levels are known to increase with the number of metabolic syndrome components present, and since they provide the physician with added information on the risk of cardiovascular disease and diabetes, many physicians include a test for hs-CRP when screening a patient for the metabolic syndrome. Certain types of medical specialists such as endocrinologists and other physicians who are especially concerned with the prevention of diabetes and heart disease, are more likely to order this test.
Copyright © 2004 E-MedHosting.com Inc. Do Diabetes Treatments Affect Inflammation?
back to top
Diabetes and high hs-CRP levels both increase the risk of having a future heart attack or stroke. Diabetes is linked to increased inflammation (detectable by the hs-CRP test), and this inflammation has harmful effects on the blood vessel walls over time.
The primary goal of diabetes treatments is to lower blood sugar levels. Diabetic patients may need to take extra medications to control their blood pressure and/or cholesterol levels, and some of these may have the additional effect of reducing inflammation.
Some diabetes treatments also reduce inflammation, as seen by the changes in blood levels of a variety of molecules including C-reactive protein, that are involved in the inflammatory process. Diabetes treatments with known anti-inflammatory effects include insulin and drugs of the insulin sensitizing kind, such as the "glitazones" and metformin.
If you are diabetic and your hs-CRP level is high, your doctor may advise you to make some lifestyle changes to reduce your risk of a heart attack or stroke, such as quitting smoking, exercising more and following a healthy diet.
Copyright © 2004 E-MedHosting.com Inc. Is C-Reactive Protein (CRP) Specifically Related To Cardiovascular Disease?
back to top
Because C-Reactive Protein (CRP) levels increase in response to a variety of stimuli in the
form of major trauma or infection, there has been some concern about whether hs-CRP levels are truly related to the risk of heart disease specifically. However several studies have now shown that measurement of high-sensitivity CRP in stable individuals is in fact highly predictive of cardiovascular events. Therefore chronically elevated CRP levels do indicate an increased risk of heart disease as well as the increased rate of atherosclerosis seen in diabetic patients.
Copyright © 2004 E-MedHosting.com Inc. At What Age Is CRP Testing Appropriate?
back to top
The best time to start getting tested for hs-CRP would probably be sometime in your 30's, when your doctor may start checking your cholesterol levels. If you are in your teens or 20's, there is evidence which strongly suggests that your current hs-CRP level is predictive of hsCRP levels later on in your life. Elevated C-Reactive Protein (CRP) levels provide information on cardiovascular risk over the following 30-40 years. This becomes very useful for your physician as he/she can detect risk years in advance and have the opportunity to initiate lifestyle and/or pharmacologic interventions in order to prevent heart attack or stroke.
Copyright © 2004 E-MedHosting.com Inc. How Can I Lower My C-Reactive Protein (CRP) Level?
back to top
Since an association between elevated hs-CRP levels and cardiovascular risk has only recently been established, it remains to be seen whether lowering C-Reactive Protein (CRP) will result in a direct lowering of cardiovascular risk. You and your physician should be on the lookout for new information on lowering CRP levels and the effect this has on cardiovascular risk.
The good news is that the best ways to lower CRP are the same as measures you should take to lower your cardiovascular risk, that is, diet, exercise, blood pressure control and stopping smoking.
Because studies have shown that people with normal cholesterol but elevated hs-CRP levels are still at higher risk than people with normal cholesterol and hs-CRP levels, CRP assessment is a useful way to identify more patients at risk for heart disease.
Copyright © 2004 E-MedHosting.com Inc. What Do Aspirin and the "Statin" Drugs Do?
back to top
Studies have shown that aspirin, an antiplatelet and anti-inflammatory drug, reduced the risk of a first-ever heart attack in men, and this protection was greatest among those individuals having high levels of inflammation as indicated by elevated hs-CRP levels. You should not start taking aspirin without consulting your physician, who will decide if it is appropriate for you based on the potential risks and benefits.
Cholesterol lowering drugs, in particular the "statins" are well-known to reduce the risk of first-ever heart attacks and strokes, as well as recurrent events. Statins work mainly by lowering LDL cholesterol levels but they also lower C-Reactive Protein (CRP), which may have an additional clinical benefit. They are currently prescribed for patients with known heart disease, high LDL cholesterol and diabetes. To learn more about the statin drugs, please see the Cardiology Patient Page by Gotto (Statins: powerful drugs for lowering cholesterol: advice for patients, Circulation 2002;105:1514–1516).
It is currently being investigated whether individuals with low LDL but high CRP levels
would also benefit from taking statin drugs, in terms of reduced cardiovascular risk. The trial that is underway to test this hypothesis is called the JUPITER trial, and if you wish to you participate in this study, please call 1-888-660-8254 or go to http://www.JUPITERstudy.com on the Internet.
Copyright © 2004 E-MedHosting.com Inc. Do patients taking statin drugs need to have hs-CRP measured in followup?
back to top
Statin drugs both lower cholesterol and lower hs-CRP levels. Very recent evidence in high risk patients from two studies, the PROVE IT trial and the REVERSAL trial, both indicate that reducing hs-CRP levels with statin therapy lowers the risk of recurrent heart attacks and cardiac deaths. This is potentially important for patient care as it suggests that getting hs-CRP levels down aggressively may be of similar importance as aggressively lowering cholesterol levels - in both of these new studies, the patients who did the best were those who not only lowered cholesterol but also lowered hs-CRP levels. The best way to do this is through lifestyle changes including weight loss, exercise, and smoking cessation. Patients who are at high risk and taking statin drugs and who have elevated hs-CRP levels may want to consult with their physicians about whether the dose of statin is optimal for them.
Copyright © 2004 E-MedHosting.com Inc. Which People Should Be Tested for hs-CRP?
back to top
According to the Centers for Disease Control and Prevention and the American Heart Association, hs-CRP evaluation should be a part of the global risk assessment in individuals concerned about their vascular risk. This testing is likely to be most useful in patients at an
intermediate level of risk, where the hs-CRP level would provide additional prognostic information allowing more patients to be aware of their increased risk so they can begin timely preventive measures by way of positive lifestyle changes. Many physicians do a hs-CRP evaluation concurrently with cholesterol evaluation, making use of the same blood sample. CReactive Protein (CRP) is by no means mandatory, but should be done when your physician sees it as appropriate.
Other patients for whom the Centers for Disease Control and Prevention and the American Heart Association endorse hs-CRP evaluation are those with a prior history of heart attack, and those admitted to hospital for acute heart disease syndromes. Patients coming to the Emergency department with chest pains may also have their CRP evaluated in order to assess their risk for coronary disease.
Apr 07 back to top
C-reactive protein (CRP) is a molecule produced in response to inflammation, which occurs
when the body is exposed to a major trauma or infection. CRP is therefore a marker of inflammation. CRP is not only produced within the liver, but also appears to be produced in both visceral fat and within coronary vessels. It has recently been discovered that CRP also plays a role in heart disease.
The amount of CRP produced by the body varies from person to person, and this is affected by an individual's genetic makeup (accounting for almost half of the variation in CRP levels between different people) and lifestyle. Higher CRP levels tend to be found in individuals who smoke, have high blood pressure, are overweight and don't exercise, whereas 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.
Copyright © 2004 E-MedHosting.com Inc.
How Is C-Reactive Protein (CRP) Associated With the Risk of Cardiovascular Disease?
back to top
Several major studies have shown that C-Reactive Protein (CRP) levels in apparently healthy men and women are strongly predictive of the future risk of heart attack, stroke, sudden cardiac death as well as the development of peripheral arterial disease. In patients already suffering from heart disease, doctors can use CRP levels to determine which patients are at high risk for recurring coronary events. Since high levels of CRP are indicative of a 2-3 fold higher risk of cardiovascular disease, your doctor may want to measure your CRP level, perhaps at the same time as measuring your cholesterol level. Even after taking into account all other risk factors, those with elevated CRP levels have a risk 50-70 percent higher.
Copyright © 2004 E-MedHosting.com Inc. How Is C-Reactive Protein (CRP) Related to the Risk of Hypertension?
back to top
In the last decade or so several studies have suggested that hypertension or high blood pressure, is in part an inflammatory disorder. As early as 1997 it was found that the risk of having a future stroke went up with increasing levels of hs-CRP in apparently healthy men. This finding was confirmed in a large study of healthy women by 2002. Since hypertension is a major risk factor for the development of stroke, these outcomes suggested to doctors that inflammation (indicated by high hs-CRP levels) and hypertension may be working together to increase the chances of having a stroke.
In more recent major studies done in initially healthy women, those having a high hs-CRP level on top of high blood pressure were at much greater risk of having a future event such as a heart attack or stroke. Furthermore, the risk of developing hypertension in the future was greater in those individuals having higher hs-CRP levels, even in the presence of low blood
pressure in the beginning. These studies have prompted further research to find out more about the role of inflammation in hypertension.
The Val-MARC (Valsartan - Managing BP Aggressively and Evaluating Reductions in hsCRP) trial is currently investigating whether blood pressure reduction with Diovan (valsartan) will decrease hs-CRP levels and if the dose of medication used would influence any effect on hs-CRP levels. If you would like to learn more or may be interested in participating in this study, please call 1-888-526-4745 or go to http://www.valmarctrial.com on the Internet.
Copyright © 2004 E-MedHosting.com Inc. Why hs-CRP ?
back to top
To measure your C-Reactive Protein (CRP) level, your doctor will need to order the "highsensitivity" CRP or hs-CRP test from the laboratory. This is a simple blood test designed for greater accuracy in measuring CRP, which allows the physician to use the result in the assessment of cardiovascular risk.
Copyright © 2004 E-MedHosting.com Inc. What Do the hs-CRP Test Results Mean?
back to top
hs-CRP levels are expressed in terms of milligrams per liter (mg/L). Concerning your hs-CRP level and cardiovascular risk, a level of less than 1mg/L indicates lower risk, a level between 1 and 3mg/L indicates moderate risk, and a level higher than 3mg/L indicates a higher risk. As research has shown, this may hold true even if your LDL cholesterol levels are low.
If your hs-CRP level is very high, above 10mg/L, you should have the test repeated after 2-3 weeks, as the high hs-CRP level may reflect an acute infection that you are experiencing at the time. You should therefore have your hs-CRP evaluated only when feeling well. If upon repeat testing your hs-CRP level remains high, then you are most probably in the higher cardiovascular risk group.
In middle-aged Americans, the average hs-CRP level is between 1.0 and 2.0 mg/L. About one quarter of Americans have a hs-CRP level above 3mg/L, placing them in the higher risk group.
Copyright © 2004 E-MedHosting.com Inc. Why Is it Important to Have Both hs-CRP and Cholesterol Measured?
back to top
High hs-CRP and high LDL or "bad" cholesterol levels represent different pathways leading to heart disease. Therefore doing measurements of both of these provides the doctor with more information about your cardiovascular risk than measuring LDL cholesterol alone. Persons with high hs-CRP and high LDL cholesterol are at greatest risk and those with low hs-CRP and low LDL cholesterol are at lowest risk.
If your hs-CRP or LDL cholesterol levels are high, your doctor may advise you to adopt some lifestyle changes such as losing weight, stopping smoking, exercising and following a recommended diet, all of which will lower your cardiovascular risk as well as hs-CRP levels. There are also some medications you may wish to consider.
Copyright © 2004 E-MedHosting.com Inc.
Is hs-CRP the Only "Novel Risk Factor" for Heart Disease?
back to top
Besides C-Reactive Protein (CRP), there are other novel risk factors for heart disease such as homosysteine and lipoprotein(a), among others. hs-CRP however is the inflammatory marker with the strongest predictive value for future cardiovascular events, and has been shown to add prognostic information to that obtained from cholesterol screening. In the future, it is possible that other markers of inflammation beyond CRP will be introduced.
Copyright © 2004 E-MedHosting.com Inc. What Role Does C-Reactive Protein (CRP) Play in Diabetes and the Metabolic Syndrome?
back to top
High hs-CRP levels also predict increased risk of developing type 2 diabetes. In some patients, this increased inflammation comes from obesity, as fat cells secrete proteins which stimulate the production of C-Reactive Protein (CRP).
Patients with the metabolic syndrome have an increased chance of developing heart disease and diabetes. Individuals are currently classified as having the metabolic sydrome if they meet 3 of the following 5 criteria: low HDL or "good" cholesterol, obesity, high triglycerides, increased blood sugar levels or high blood pressure. These however don't represent all the components or contributing factors in the metabolic syndrome. CRP levels are known to increase with the number of metabolic syndrome components present, and since they provide the physician with added information on the risk of cardiovascular disease and diabetes, many physicians include a test for hs-CRP when screening a patient for the metabolic syndrome. Certain types of medical specialists such as endocrinologists and other physicians who are especially concerned with the prevention of diabetes and heart disease, are more likely to order this test.
Copyright © 2004 E-MedHosting.com Inc. Do Diabetes Treatments Affect Inflammation?
back to top
Diabetes and high hs-CRP levels both increase the risk of having a future heart attack or stroke. Diabetes is linked to increased inflammation (detectable by the hs-CRP test), and this inflammation has harmful effects on the blood vessel walls over time.
The primary goal of diabetes treatments is to lower blood sugar levels. Diabetic patients may need to take extra medications to control their blood pressure and/or cholesterol levels, and some of these may have the additional effect of reducing inflammation.
Some diabetes treatments also reduce inflammation, as seen by the changes in blood levels of a variety of molecules including C-reactive protein, that are involved in the inflammatory process. Diabetes treatments with known anti-inflammatory effects include insulin and drugs of the insulin sensitizing kind, such as the "glitazones" and metformin.
If you are diabetic and your hs-CRP level is high, your doctor may advise you to make some lifestyle changes to reduce your risk of a heart attack or stroke, such as quitting smoking, exercising more and following a healthy diet.
Copyright © 2004 E-MedHosting.com Inc. Is C-Reactive Protein (CRP) Specifically Related To Cardiovascular Disease?
back to top
Because C-Reactive Protein (CRP) levels increase in response to a variety of stimuli in the
form of major trauma or infection, there has been some concern about whether hs-CRP levels are truly related to the risk of heart disease specifically. However several studies have now shown that measurement of high-sensitivity CRP in stable individuals is in fact highly predictive of cardiovascular events. Therefore chronically elevated CRP levels do indicate an increased risk of heart disease as well as the increased rate of atherosclerosis seen in diabetic patients.
Copyright © 2004 E-MedHosting.com Inc. At What Age Is CRP Testing Appropriate?
back to top
The best time to start getting tested for hs-CRP would probably be sometime in your 30's, when your doctor may start checking your cholesterol levels. If you are in your teens or 20's, there is evidence which strongly suggests that your current hs-CRP level is predictive of hsCRP levels later on in your life. Elevated C-Reactive Protein (CRP) levels provide information on cardiovascular risk over the following 30-40 years. This becomes very useful for your physician as he/she can detect risk years in advance and have the opportunity to initiate lifestyle and/or pharmacologic interventions in order to prevent heart attack or stroke.
Copyright © 2004 E-MedHosting.com Inc. How Can I Lower My C-Reactive Protein (CRP) Level?
back to top
Since an association between elevated hs-CRP levels and cardiovascular risk has only recently been established, it remains to be seen whether lowering C-Reactive Protein (CRP) will result in a direct lowering of cardiovascular risk. You and your physician should be on the lookout for new information on lowering CRP levels and the effect this has on cardiovascular risk.
The good news is that the best ways to lower CRP are the same as measures you should take to lower your cardiovascular risk, that is, diet, exercise, blood pressure control and stopping smoking.
Because studies have shown that people with normal cholesterol but elevated hs-CRP levels are still at higher risk than people with normal cholesterol and hs-CRP levels, CRP assessment is a useful way to identify more patients at risk for heart disease.
Copyright © 2004 E-MedHosting.com Inc. What Do Aspirin and the "Statin" Drugs Do?
back to top
Studies have shown that aspirin, an antiplatelet and anti-inflammatory drug, reduced the risk of a first-ever heart attack in men, and this protection was greatest among those individuals having high levels of inflammation as indicated by elevated hs-CRP levels. You should not start taking aspirin without consulting your physician, who will decide if it is appropriate for you based on the potential risks and benefits.
Cholesterol lowering drugs, in particular the "statins" are well-known to reduce the risk of first-ever heart attacks and strokes, as well as recurrent events. Statins work mainly by lowering LDL cholesterol levels but they also lower C-Reactive Protein (CRP), which may have an additional clinical benefit. They are currently prescribed for patients with known heart disease, high LDL cholesterol and diabetes. To learn more about the statin drugs, please see the Cardiology Patient Page by Gotto (Statins: powerful drugs for lowering cholesterol: advice for patients, Circulation 2002;105:1514–1516).
It is currently being investigated whether individuals with low LDL but high CRP levels
would also benefit from taking statin drugs, in terms of reduced cardiovascular risk. The trial that is underway to test this hypothesis is called the JUPITER trial, and if you wish to you participate in this study, please call 1-888-660-8254 or go to http://www.JUPITERstudy.com on the Internet.
Copyright © 2004 E-MedHosting.com Inc. Do patients taking statin drugs need to have hs-CRP measured in followup?
back to top
Statin drugs both lower cholesterol and lower hs-CRP levels. Very recent evidence in high risk patients from two studies, the PROVE IT trial and the REVERSAL trial, both indicate that reducing hs-CRP levels with statin therapy lowers the risk of recurrent heart attacks and cardiac deaths. This is potentially important for patient care as it suggests that getting hs-CRP levels down aggressively may be of similar importance as aggressively lowering cholesterol levels - in both of these new studies, the patients who did the best were those who not only lowered cholesterol but also lowered hs-CRP levels. The best way to do this is through lifestyle changes including weight loss, exercise, and smoking cessation. Patients who are at high risk and taking statin drugs and who have elevated hs-CRP levels may want to consult with their physicians about whether the dose of statin is optimal for them.
Copyright © 2004 E-MedHosting.com Inc. Which People Should Be Tested for hs-CRP?
back to top
According to the Centers for Disease Control and Prevention and the American Heart Association, hs-CRP evaluation should be a part of the global risk assessment in individuals concerned about their vascular risk. This testing is likely to be most useful in patients at an
intermediate level of risk, where the hs-CRP level would provide additional prognostic information allowing more patients to be aware of their increased risk so they can begin timely preventive measures by way of positive lifestyle changes. Many physicians do a hs-CRP evaluation concurrently with cholesterol evaluation, making use of the same blood sample. CReactive Protein (CRP) is by no means mandatory, but should be done when your physician sees it as appropriate.
Other patients for whom the Centers for Disease Control and Prevention and the American Heart Association endorse hs-CRP evaluation are those with a prior history of heart attack, and those admitted to hospital for acute heart disease syndromes. Patients coming to the Emergency department with chest pains may also have their CRP evaluated in order to assess their risk for coronary disease.
Related Documents
C Reactive Protein A To Z
June 2020 5
A To Z Of C
July 2020 14
A To Z Technical
June 2020 13
Ceo - A To Z
May 2020 10
A To Z
November 2019 18
A To Z - Writing
November 2019 26More Documents from ""
Job-hunting Tips For Finding The Right Job
July 2020 14
Dialysis A To Z
June 2020 19
Obama's Nobel Prize A Shocker
July 2020 14
Update On Novel Influenza A (h1n1) Infection
June 2020 8
Freud And Freudian
June 2020 15