CRP Predicts Heart Disease Better Than Cholesterol

By Dr. W. Gifford Jones

June 29, 2003

How much trust would you put in a test when it's results are 50 percent wrong? It would do little to ease the psyche. Yet for years millions of people have shown blind faith in the cholesterol blood test as the prime predictor of heart disease. This year another one-and-a-half million North Americans will experience the crushing chest pain of coronary attack. But half of these patients will show normal blood cholesterol levels. Now a study from The Harvard Medical School may make another blood test a household word.

Dr. Paul Ridker has followed the fate of 28,000 women for eight years. He found that women with high levels of C- Reactive Protein (CRP) were twice as likely to have a heart attack or stroke. And that women with a high CRP were more likely to develop heart disease than women with high cholesterol.

This was shocking news. It meant that people with normal cholesterol, who assumed they had whistle-clean arteries, had no idea they were at risk for coronary attack.

The Harvard report proved what I've claimed for years. That there's been so much "cholesterolphobia", particularly in North America, that other theories for heart attack have been swept aside. This explains what happened to CRP studies.

In 1931 Oswald Avery, a Rockefeller Institute researcher, discovered that CRP levels increased immediately after infection with the Streptococcus A bacteria. In effect, CRP was able to detect the presence of inflammation.

Then in 1952 a research paper suggested that CRP could be used to diagnose acute myocardial infarction. But for 50 years this idea lay dormant, for a couple of reasons.

Cholesterol was discovered and the race was on to find drugs to lower it. Moreover, the financial profit from cholesterol lowering drugs ensured that anything else got lost in the shuffle.

For instance, a Finnish study years ago showed that patients with a high levels of blood fibrinogen have 5X the risk of heart attack. But there was no money to be made and no solution for this small blood particle associated with the clotting process.

But apart from the profit motive no one related heart attack to inflammation. It was when researchers realized that half the victims of heart attack had normal cholesterol that doctors started to look elsewhere for answers.

Now doctors believe there's reasonable evidence that coronary attack is associated with inflammation and infection. And that the presence of C-Reactive Protein indicates blood vessels are inflamed.

The problem is doctors do not yet know what to do about an elevated CRP. First, CRP indicates that inflammation is present, but does not locate it. Second, we do not know how to reduce CRP or even if it would result in fewer heart attacks.

Currently studies are being conducted to determine whether the use of cholesterol-lowering and other medication will have any effect on CRP. But it will be several years before we know the answer.

So if you can't treat an increased CRP, why bother to test for it? This finding could act as a warning bell that potential trouble lies ahead for those living a faulty lifestyle. Hopefully, it could stimulate them to stop smoking, get off the couch and lose weight. Or to consider taking a baby Aspirin (81 milligrams) a day which helps to fight inflammation. Be sure to ask your doctor about it.

An elevated CRP may also alert doctors and dentists to look for areas of inflammation and infection. Today, much more is needed to improve the oral hygiene of Canadians. It's estimated that by age 60 one in three Canadians have lost all their teeth largely due to gingivitis (inflamed gums). There is also evidence that gingivitis is associated with coronary artery disease.

To prevent gingivitis visit your dentist twice a year. But there's no substitute for brushing and flossing the teeth after each meal. I also advise patients to use an electric toothbrush that is more efficient in keeping gums healthy.

The most reliable test for CRP is the high-sensitivity CRP.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod