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Study questions widespread use of C-reactive protein test to assess cardiovascular risk

A new study concludes that widespread screening for cardiovascular risk by measuring blood levels of C-reactive protein (CRP), a protein produced by the liver, should not be advocated. Researchers at the University of Maryland School of Medicine in Baltimore analyzed data from more than 15,000 adult men and women and found that CRP appears to be tightly linked to traditional risk factors for heart disease rather than being an independent risk factor. The study is published in the October 10, 2005, Archives of Internal Medicine.

C-reactive protein (CRP) is released by the liver in response to inflammation related to an infection, injury, or conditions such as arthritis. Inflammation also has been associated with the cause and progression of cardiovascular disease, particularly in the build up of fatty deposits in the lining of arteries.

The researchers found that elevated CRP goes hand in hand with traditional risk factors for heart disease, such as smoking, obesity, high blood pressure or elevated cholesterol, and rarely occurs in their absence. CRP levels are defined as normal (less than 1 milligram per liter (mg/L), borderline-high (1-3 mg/L) and high (greater than 3 mg/L).

"We believe that high C-reactive protein is truly related to the company it keeps," says principal investigator Michael Miller, M.D., director of preventive cardiology at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine. "The CRP test gained popularity in the late 1990's when it was believed that only 50 percent of heart attacks could be explained by traditional risk factors," says Dr. Miller. "However, this turned out to be one of the greatest myths in cardiovascular medicine as recent studies have affirmed that more than 90 percent of heart attacks can be accounted for by traditional risk factors, as well as poor diet, sedentary lifestyle and mental stress."


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Contact: Bill Seiler
bseiler@umm.edu
410-328-8919
University of Maryland Medical Center
10-Oct-2005


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