Beyond Cholesterol 02 ( By TIME - Nov. 25. 2002 )

CRP, for C-reactive protein, is a substance manufactured by the liver in response to the immune system's alarms. It can easily be picked up in the blood and provides a convenient measure of how inflamed the heart arteries may be. Ridker's team, which pioneered the study of CRP's role in heart disease, tracked the levels of both CRP and LDL ("bad" cholesterol) in nearly 28,000 women for eight years. They found that women with high levels of CRP were twice as likely to have heart disease as those with high LDL, and that many women who later suffered heart attacks would have been given a clean bill of health on the basis of their low LDLs. For that reason, he and others would like to see CRP join cholesterol as part of the battery of tests in a standard blood workup. "These data," says Ridker, "tell us that continued reliance on LDL alone is really not serving our purpose very well."

But CRP can be tricky; it can jump as much as 10-fold when a person is fighting a cold or the flu. And it shouldn't be used in place of a cholesterol test. The latter measures how much fat is lodged in the vessels of the heart; the CRP test shows how likely it is that those plaques will burst.

If your CRP levels are high, don't despair. They can be lowered. In fact, the lifestyle changes and medications that doctors recommend to lower cholesterol do double duty and also reduce CRP. Avoiding fatty red meat, eating more fruits and vegetables and exercising should be the first response--if making those changes is not enough, statin drugs may help.

The broader implications of the new study will require further research. People who suffer from chronic inflammatory responses like arthritis may be at higher risk of heart disease. There may also be a cancer link, for among the substances released during the inflammatory response are free radicals that can trigger tumor growth. Maybe that's why doctors' advice to eat more nutrient-rich vegetables and less fat works equally well for a patient who is at risk for cancer or for heart disease. They've been treating the same underlying cause all along.


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