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Half of American Adults Have Elevated CRP
posted 05/19/04
This puts a significant number of Americans at risk for coronary heart disease.

Almost half of the adults in the United States probably have elevated C-reactive protein (CRP) levels, and the rate is about 30% higher in women than men, according to a presentation at the American College of Cardiology Annual Scientific Session 2004.

“Elevated CRP appears to be a prevalent condition in the United States. Correlates include known risk factors for CHD [coronary heart disease]. However, there are also risk factors for elevated CRP that were not known risk factors for CHD, and these warrant further investigation,” said C. David Klingman, PhD, summing up his study at the annual scientific sessions of American College of Cardiology.

The surprising risk factors for elevated CRP were being a woman and not graduating from high school, he added. The researchers examined several risk factors for elevated CRP using the National Health and Nutrition Examination Survey (NHANES), a recurring national survey of health conditions and behaviors. CRP is a marker of arterial inflammation and may predict CHD, according to Klingman, director of health economics at ValueMedics Research LLC in Arlington, Va. “However, little is known about elevated CRP in terms of its natural prevalence in the U.S. and its association with other CHD risk factors,” he said.

By using NHANES data, the researchers hoped to describe this prevalence, identify the risk factors associated with elevated CRP and assess the independent effects of those factors.

The researchers conducted a weighted multivariate logistic regression analysis using SUDAAN that included gender, age, obesity, total cholesterol, fasting triglyceride and blood glucose levels, alcohol use, educational attainment, and history of CHD, diabetes, hypertension or arthritis.

The researchers included anyone with CRP levels from 0.1 mg/L to 10 mg/L in their analysis among 4,444 respondents — who were at least 20 years old — as the study’s nationally representative sample.

They found levels of CRP of 2 mg/L or higher in 47.1% of the population – an estimated 76.5 million adults. Factors that led to an increase in CRP levels included obesity (odds ratio [OR] 3.54), being between ages 55 and 74 (55-64, OR 1.99; 65-74, OR 2.29), not graduating from high school (OR 2.06), being a woman (OR 1.85) and having high triglyceride levels (OR 1.41). Factors that were not significantly associated with elevated CRP levels included ethnic background or country of birth, smoking and family history of myocardial infarction or angina.

“As you can see, nearly half of the population has CRP higher than 2.0 – 47.1%. This is about 30% higher in women than men,” Klingman said.

“Variables that had significant relationships with elevated CRP included obesity, less than a high school education, age and having high triglyceride levels. Obese adults were about 3½ times more likely to have elevated levels of CRP than non-obese adults,” he explained.

Klingman’s study only found three known risk factors for CHD that were significantly associated with elevated CRP: obesity, two age groups and elevated triglycerides. What surprised the authors was that two variables that are not known risk factors for CHD turned out to be significant: being female and not graduating from high school, he said. He said more research was needed to determine the reasons and how these data should be used.

“The results have implications for people who have high CHD risks, but might not otherwise fall under current guidelines for therapy.” AstraZeneca sponsored the study.

Klingman D, Williams S, Smith T, et al. Correlates of elevated C-reactive protein among adults in the United States: Findings from the 1999-2000 National Health and Nutrition Examination Survey. Abstract #812-3. Presented at the American College of Cardiology Annual Scientific Session 2004. New Orleans.

Source: Diabetes In Control.com.

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