Which is the Horse, and Which is the Cart? CRP or CVD?

[Guest guest]

Hi folks:

By the same author .............. interesting analysis, but the

conclusion seems odd to me.

" High attributable risk of elevated C-reactive protein level to

conventional coronary heart disease risk factors: the Third National

Health and Nutrition Examination Survey.

M, Zhan M, Havas S.

Department of Medicine, University of land School of Medicine,

Baltimore, USA. mmiller@...

BACKGROUND: C-reactive protein (CRP), a marker of systemic

inflammation, is predictive of coronary heart disease (CHD) events.

However, the extent to which high CRP levels (>3 mg/L) may be

attributable to high cholesterol levels and other CHD risk factors

has not been well defined. METHODS: The prevalence of high CRP levels

in the third National Health and Nutrition Examination Survey (n = 15

341) was studied using CHD risk-factor cut points designated as

abnormal (total cholesterol values, >or=240 mg/dL [>or=6.22 mmol/L];

fasting blood glucose levels, >or=126 mg/dL [>or=6.99 mmol/L]; blood

pressure, >or=140/90 mm Hg; body mass index [bMI], >or=30 kg/m(2);

high-density lipoprotein cholesterol values, <40 mg/dL [<1.04 mmol/L]

for men and <50 mg/dL [<1.30 mmol/L] for women; triglyceride levels,

>or=200 mg/dL [>or=2.26 mmol/L]; current smoking status) or

borderline (total cholesterol values, 200-239 mg/dL [5.18-6.19

mmol/L]; fasting blood glucose levels, 100-125 mg/dL [5.55-6.94

mmol/L]; blood pressure, 120-139/80-89 mm Hg; BMI, 25.0-29.9 kg/m(2),

and triglyceride values 150-199 mg/dL [1.70-2.25 mmol/L], former

smoking status), or normal. RESULTS: Weighted multiple logistic

regression analysis demonstrated that high CRP level was

significantly more common with obesity (odds ratio [OR], 3.78; 95%

confidence interval [CI], 3.28-4.35]), overweight (OR, 1.88; 95% CI,

1.62-2.18), and diabetes (OR, 1.91; 95% CI, 1.54-2.38) and that high

CRP level was rare in the absence of any borderline or abnormal CHD

risk factor in men (4.4%) and women (10.3%). Overall, the risk of

elevated CRP level attributable to the presence of any abnormal or

borderline CHD risk factor was 78% in men and 67% women. ........

CONCLUSIONS: These data suggest that elevated CRP levels in the

general population are in large measure attributable to traditional

CHD risk factors. Moreover, CRP level elevation is rare in the

absence of borderline or abnormal risk factors. As such, CRP

measurements may have limited clinical utility as a screening tool

beyond other known CHD risk factors. "

PMID: 16216995.

Might a better conclusion have been something like: " Further

research is necessary to determine whether CRP or the standard risk

factors are better for predicting of CVD " . ???? If we knew the

answer to that, then we could pay more attention to the more useful

measure of risk.

Jmo, naturally.

Rodney.