However, in 2003, the American Heart Association and the Centers for Disease Control and Prevention issued a joint scientific statement that recommended against the general screening of the adult population for CRP. Instead, the statement said that CRP measurements should be reserved for patients at intermediate risk for heart disease, who have a 10 to 20 percent risk of developing the disease over ten years. The statement also called for additional studies of the CRP test.
Dr. Miller believes that CRP screening is unlikely to contribute sufficient insight beyond traditional risk factors and may even be counterproductive. "The great concern of CRP screening is that it may provide false assurance to men and women who may be at increased risk of a heart attack despite normal CRP levels," says Dr. Miller. "Because the majority of people at risk for a heart attack do not have high CRP, normal levels at screening may make obese patients or smokers, for example, less motivated to lose weight or kick the habit." On the other hand, according to Dr. Miller, if a high CRP is found on routine screening, then therapies that reduce high blood pressure, glucose, cholesterol and triglycerides will also lower CRP. "We should be making these adjustments anyway, regardless of CRP levels," he adds.
Dr. Miller says the good news is that in the absence of risk factors, high CRP is very rare. "If you exercise, don't smoke, have normal levels of blood pressure, cholesterol and glucose and are not overweight, the likelihood of having a high CRP is only one in 2,000," he says. Rather than screening for CRP, Dr. Miller says "Let's work more intensively to reduce the known culprits, such as obesity and diabetes, which are growing to epidemic proportions and have become a major public heal
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Contact: Bill Seiler
bseiler@umm.edu
410-328-8919
University of Maryland Medical Center
10-Oct-2005