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CRP & Heart Risk

Does high CRP increase the risk of heart disease in healthy women?

Most of the information on CRP in healthy women has come from the ongoing Women’s Health Study of almost 28,000 female health professionals 45 years and older. Women with high CRP and low LDL (bad) cholesterol had a higher risk [of having a heart attack or dying from heart disease than women with low CRP and high LDL cholesterol.2 Another analysis of more than 15,000 women found that both CRP and blood pressure independently predicted risk of cardiovascular problems including heart attack or stroke. Women with high CRP and high blood pressure were 3 times more likely to suffer cardiovascular problems than women with low levels of both.8 It was also shown that CRP helps predict cardiovascular problems in women with the metabolic syndrome.9 The metabolic syndrome is a clustering of risk factors including higher than normal blood pressure and blood sugar levels and a large waistline (more than 35 inches).

Does high CRP increase the risk of heart problems in people with heart disease?

High CRP is associated with a higher risk of dying early in men and women with stable angina.10, 11 This may be because fatty plaque buildup appears to progress more rapidly in angina patients with high CRP.12 High CRP is also associated with a higher risk of heart problems in patients hospitalized for unstable angina/mild heart attack.13 A CRP test may be particularly helpful when the usual blood tests are negative (e.g., troponins).14 15

During a typical heart attack, CRP levels rise dramatically, peaking at days 2 to 4, and returning to baseline within 4 weeks. Testing for CRP early on does not help predict who is at risk for dying or suffering a repeat attack.10.16 There is some evidence that a CRP reading taken when levels have stabilized may identify patients at a higher risk of dying early.17 18

Is high CRP a stronger risk factor for men than women?

There is evidence that high CRP may be more of a risk for men than women. CRP levels are higher in women than in men, yet men develop heart disease more often and at an earlier age than women.

An analysis from the Nurses’ Health Study and the Health Professionals Follow-up study compared 265 men and 239 women who had a heart attack or died from heart disease with similar men and women who did not. While high CRP was associated with an 80% increase in the risk of these heart problems in men, there was no association seen in women.19 A study of nearly 4,000 men and women 65 years of age or older found that 33% of the men with high CRP developed heart disease within 10 years compared with only 17% of women with high CRP.20

Does lowering CRP help the heart?

It is not clear if lowering CRP itself can reduce your heart risk. However, cholesterol-lowering statin medications (which also lower CRP levels) can cut heart risk in women with high CRP. In 2009, the JUPITER study found that among 6,801 otherwise healthy women with elevated CRP, those taking statin drugs had a 46% lower chance of developing heart problems, even if they did not have high cholesterol. However, it is not clear if these benefits were caused by lowering CRP, lowering cholesterol, or by some other mechanism. If you are concerned about the effect CRP is having on your heart risk, discuss with your doctor whether treatment with statin drugs may be right for you.

Aspirin,30, 31 exercise,32, 33 weight loss,34 moderate alcohol consumption,35 and following the Mediterranean diet36, 37 (a diet high in fruits, vegetables, bread, and other cereals, beans, nuts, olive oil, and fish) can also lower CRP levels, and have other beneficial effects on your heart health as well.

Next: CRP Tests


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