Inflammation is key to gauging heart risk

Doctors should test patients' blood for C-reactive protein, 2 medical studies say.
The Boston Globe
January 6, 2005
Inflammation in the heart's arteries is as important as cholesterol in determining whether a heart patient's condition will worsen, according to two major studies being released today.
That finding raises the possibility that doctors could save thousands of lives if they aggressively monitor a key indicator of inflammation's presence.
Most Americans have had their cholesterol levels tested, and more than 10 million take drugs called statins to reduce their levels of LDL, or "bad," cholesterol. But few primary-care doctors routinely test patients' blood concentration of C-reactive protein, the leading measure of inflammation.
The authors of the papers, published in the New England Journal of Medicine, say their findings are so powerful that doctors should immediately change their practices, at least for patients with heart disease, screening their blood for CRP and aggressively treating elevated levels with higher doses of statins, increased exercise and diet changes.
"It's simply no longer enough to monitor cholesterol if we want to do the most for our patients," said Paul M. Ridker, lead author of a CRP study of heart attack patients at Brigham and Women's Hospital. "We need to achieve the dual goals of not only low cholesterol but also low CRP levels."
A separate study by researchers at the Cleveland Clinic, which looked at the progression of plaque buildup inside patients' heart arteries after taking statins, suggested that C-reactive protein makes the plaque buildup thicker by promoting inflammation.