Heartfelt news

Sept. 1, 2002
Heart has new worst enemy: Study on inflammation alters medical theory, shouted the headline on the front page of the Tampa Tribune last month.Over the past few years, a radical shift has taken place in the medical worlds perspective on the causes of heart disease. Cholesterol has long been blamed as the primary villain, but nagging questions just havent gone away. For example, why is it that so many people with high cholesterol never have heart attacks and why do many people who suffer heart attacks not, in fact, have high cholesterol? Fully half of all heart attack victims have normal or low cholesterol levels. The plumbing model of arteries clogged with bad fat was just too simple, many doctors believed. There had to be something else.Now, a new villain has entered the picture: inflammation. Dr. Sherry Woodhouse of Cleveland Clinic Florida addressed this issue in her March 2002 MLO cover piece about C-reactive protein as a cardiovascular disease risk factor. High levels of CRP in the blood indicate inflammation. Evidence continues to mount that the inflammatory process plays an important part in the buildup of fatty deposits in the lining of the arteries
Low-grade inflammation in various places in the body from inflamed blood vessel walls to inflamed gums can apparently contribute to the development of
atherosclerosis. Additionally, inflammation may contribute to the rupture of existing
atherosclerosis, triggering the formation of blood clots and resulting in a potential heart attack or stroke. CRP levels in the blood are elevated when inflammation is present, and researchers have found that CRP levels may be elevated for many years before an actual stroke or heart attack occurs. A study published several years ago in the New England Journal of Medicine showed that men with the highest levels of CRP, compared to men with lower CRP levels, had three times the risk of heart attack and twice the risk of stroke. This study also showed that elevated levels of CRP could presage first heart attacks as far as eight years in advance.
What does all this mean to the clinical laboratory? The Centers for Disease Control and Prevention and the American Heart Association are currently formulating guidelines, which will probably be released this fall, for monitoring CRP levels. Broad testing will almost certainly be recommended. The day may not be far away when doctors will be urged to routinely test middle-aged Americans for inflammation.No matter what our CRP level is, or the amount of low-grade inflammation we happen to be walking around with, even before the new testing guidelines are released, we know this right now: The American Heart Association tells us that we can significantly reduce our risk for heart disease by:Stopping smoking and avoiding other peoples tobacco smoke;Keeping our blood pressure in check;Eating a healthy diet low in saturated fat, cholesterol, and sodium;Maintaining an active lifestyle and a healthy weight;And managing diabetes, if we have it.In short, dont wait for testing: Eat smart, dont smoke, and exercise. Well all be better off for it.Celia Stevens
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2002 Nelson Publishing, Inc. All rights reserved.