Usefulness of cardiovascular disease test questioned

HANOVER, NH -- Researchers with Dartmouth Medical School and the Veterans Affairs Outcomes Group at the White River Junction (Vt.) VA Medical Center are questioning the usefulness of the C-Reactive Protein (CRP) test for guiding decisions about the use of cholesterol-lowering medication.

The researchers show that adding CRP testing to routine assessments would increase the number of Americans eligible for cholesterol-lowering treatment by about 2 million if used judiciously, and by over 25 million if used broadly with most of these people being at low risk for heart attacks or heart disease. The authors argue that the medical community should focus energies on treating high-risk patients before expanding the pool to include so many low-risk patients. Their study was published in the February issue of the Journal of General Internal Medicine.

"There is a push to use this test, and that probably doesnt make much sense," says Steven Woloshin, one of the authors on the paper and an associate professor of community and family medicine at Dartmouth Medical School (DMS).

According to co-author Lisa Schwartz, associate professor of medicine at DMS, "A general population use of the test would identify millions of low-risk people, and we don't know if exposing them to cholesterol medications will do more good than harm. Plus, focusing on low-risk people seems misplaced since over half of high-risk people, who we know are helped by treatment, remain untreated."

Woloshin and Schwartzs co-authors are H. Gilbert Welch and Kevin Kerin, all of whom are affiliated with Veterans Affairs Outcomes Group and Dartmouth Medical School. Woloshin, Schwartz, and Welch are also part of Dartmouths Center for Evaluative Clinical Sciences.

For this study, the team analyzed nationally representative data from more than 2,500 people who participated in the 1999-2002 National Health and Nutrition Examination Study (NHANES). They discovered tha

Contact: Genevieve Haas
Dartmouth College

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