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In This Issue:
Ridker’s CRP Research Alters Federal Guidelines for Assessing Heart Disease Risk
The work of BWH’s own Paul Ridker, MD, MPH, director of the Center for Cardiovascular Disease Prevention, has influenced the first change in the federal guidelines for assessing cardiovascular disease risk in more than twenty years. Thanks to groundbreaking science in the labs of BWH, Ridker and his team have proved that c reactive protein (CRP) may actually be more powerful than cholesterol in measuring a person’s risk of suffering a heart attack or stroke.
“The data represents a fundamental shift in our thinking about cardiovascular disease and its prevention,” said Ridker. “It is no longer acceptable for physicians to focus solely on cholesterol since the evidence is overwhelming that those with low cholesterol but high CRP are, in fact, a very high-risk group.”
CRP—measured by a simple, inexpensive blood test—is a marker of inflammation in the bloodstream that is produced in the liver when arteries become inflamed
Ridker’s findings were published in the New England Journal of Medicine last November and then incorporated into new guidelines from the Centers for Disease Control and the American Heart Association that were published in Circulation this January. The new guidelines recommend that physicians consider use of CRP testing on patients considered at moderate risk of heart disease.
Until recently, CRP was not widely known or used as a predictor of heart disease risk. However, it is now recommended that individuals with a 10 to 20 percent risk of heart disease over ten years have their CRP tested to determine if they are at an increased risk. Work from BWH suggests that this recommendation may well be conservative as many others are also likely to benefit.
“CRP tests could have a substantial impact on the health of Americans, since it is estimated that 40 percent of adults in the United States fall into this at-risk category,” said Ridker, who explained that without CRP testing, many of those at-risk are routinely missed with conventional screening procedures.
The next step for Ridker and his team is to examine whether or not statin drug therapies (typically prescribed to patients with high cholesterol) are an effective treatment to reduce cardiovascular risk in people who have normal cholesterol levels, but high CRP—a patient population that lacks generally accepted treatment options. The new trial is called JUPITER, and is being launched nationwide this month.
In the meantime, Ridker recommends that individuals identified with high CRP levels, “reduce their risk with lifestyle changes such as exercise, consuming a healthy diet and smoking cessation.”
To learn more about Ridker’s revolutionary CRP research, visit the Press Room on BWH’s website—www.brighamandwomens.org—to locate press releases that summarize his work.