C-reactive protein levels (CRP levels) have been used for many years to monitor the non-specific acute phase response to most forms of infection, tissue damage, and inflammation. By the mid 1990s technical progress had been made in achieving much greater immunoassay sensitivities and it was soon realized that CRP levels could be used to predict future coronary events. It is now time for a high sensitivity CRP test to be as routine as a lipid panel test in monitoring progress toward a cardioprotective blood lipid status.
In the ten years before the publication of results showing that high dose statin treatment had the potential to stop or even reverse atherosclerotic plaque there were parallel research studies which combined to give hope that an era is arriving in which it is realistic to believe that in the near future it will be possible to reverse atherosclerotic plaque, preventing most heart attacks and strokes, restoring plaque damaged vascular systems to a healthy status, leading the way for individuals to achieve a healthy optimal longevity.
It is significant to note that much of this research was based upon observations in previous decades that individuals who followed an exercise and plant-based dietary regimen had a low incidence of cardiovascular disease and indeed today such lifestyle changes can do much to halt and reverse arterial damage. Further studies on the small proportion of the population who are genetically fortunate and live well beyond a century of age revealed either very high HDL-cholesterol lipid levels or very low LDL-cholesterol levels with a corresponding absence of atherosclerosis and consequent cardiovascular problems as well as other degenerative disorders we are accustomed to associate with aging.
Before 2004 statins were being used to lower cholesterol levels in patients at risk of cardiovascular events in the belief this would reduce risk. A remarkable start to new treatment modalities began in that year when it was learned that high dose statin treatment resulted in a halt to plaque progression when LDL-cholesterol levels were dropped below 70 mg/dL with reversal of plaque occurring as LDL-cholesterol levels were taken lower. An unexpected finding was that the high dose statin regimen had also resulted in a significant lowering of C-reactive protein levels; a blood protein associated with general clinical inflammation throughout the body.
So now in mid 2006 millions of patients are taking a statin to lower LDL-cholesterol. At the moment only very high risk patients are treated to below 70 mg/dL; however current research indicates that LDL-cholesterol levels can be taken much lower without harm. The research continues examining potential health benefit.
The benefit of raising HDL-cholesterol is now a major focus of research by pharmaceutical companies. When discovered, proven, and safe, such an HDL-cholesterol raising medication along with a statin will accelerate the process of atherosclerotic plaque reversal.
This association between plaque accretion in the arteries and the levels of the various lipids in the blood is explained in more detail in ErinPharm Central.
Plaque accretion alone is not the immediate cause of heart attack or stroke. It is when the plaque becomes damaged or ruptured, releasing its contents into the blood stream, causing blood clot formation and it is that total amount of debris sweeping through the bloodstream that causes the heart attack or stroke.
It has been observed that a low level of bodily inflammation, as measured with a C-reactive protein level, is associated with a lower level of heart attack or stroke. So it is important to have a C-reactive protein measurement done along with the lipid panel of LDL-cholesterol, HDL-cholesterol, and triglycerides. Since taking a statin and omega-3 fish oils (to lower triglycerides) will combine to lower C-reactive protein levels it provides a measure of comfort to an individual to have a high sensitivity C-reactive protein level measured since it's quite possible to reach a level below 0.1 mg/L and thus achieve maximum cardioprotection.
hs-CRP lower than 1.0 mg/L is low risk
hs-CRP between 1.0 and 3.0 mg/L is average risk
hs-CRP higher than 3.0 mg/L is high risk
Arterial health can also be damaged by hypertension (high blood pressure). It is a condition often undiagnosed or ignored in and by the general population. It is a 'silent killer' since it can exist in an individual unaware of their high blood pressure for many years insidiously and incrementally damaging the blood circulation system prior to a catastrophic cardiovascular incident. The current impetus toward having households add a home blood pressure monitor to gauge the daily blood pressure status of those with hypertension could well raise the profile of the importance of regular blood pressure monitoring. ErinPharm recommends the Omron brand of blood pressure monitor as being inexpensive and easy to use. New data revealed May 2008 confirm that hypertension control in the general population appears to be better in the United States than in Europe though diabetics are ill served by the latest US guidelines and only about half of US patients achieve a blood pressure objective. This data comes from a comprehensive multi-country survey by investigators led by Dr. Y. Richard Wang, of Temple University and University of Pennysylvania, in which a total of 21,053 patients with a primary or secondary diagnosis of hypertension in six countries were evaluated. These patients had visited 1,284 primary care physicians and 291 cardiologists. With a definition of control as a blood pressure less than 140/90 mm Hg it was found that 53% of US patients reached that objective compared to 27% to 40% of Europeans. In Canada new guidelines for hypertension management were released to the public in January 2007 and stressed the importance of recognizing "high normal" blood pressure, i.e. 130-139/85-89 mm Hg, and the warning that more than half of such individuals will develop hypertension within four years if they do not make lifestyle changes. The point is also made that for individuals who do not follow a healthy lifestyle more than 90% will develop hypertension. Since guidelines, medications, and lifestyle changes can and will bring blood pressure to a healthy level over a time period of up to six weeks there is a need to overcome this societal inertia on the part of health care professionals and the general population to not actively seek blood pressure normalization. Yes, it does take significant effort at times, needs ongoing attention, requires a personal commitment on the part of the patient BUT it will result in a healthier way of life with a much reduced risk of heart attack or stroke. The next few years will see the launch of a number of new antihypertensive drugs and combination 'polypills'. In India a 'polypill' with two antihypertensives, aspirin, and a statin is expected to gain acceptance. The years to come will see major advances in this combined approach to arterial health.
C-reactive protein Aiming at a healthy longevity.
I invite you to become a member of The Life Extension Foundation........John Fahey
John L. Fahey, Ph.D.
Life Extension Foundation member.
hs-CRP is high sensitivity C-reactive protein.