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Heart disease differs among the sexes and races.

A protein in the blood that is considered to be a key indicator of future heart disease may vary considerably in women and men and between African-Americans and Caucasians, according to research at the University of Texas Southwestern Medical Center in Dallas.

C-reactive protein (CRP) is released as part of the human body's inflammation response. Infections and inflammation caused by various illnesses can cause CRP levels in the blood to rise. Abnormal fatty deposits on the interior walls of arteries that are prone to rupture and cause heart attacks may also cause higher levels of CRP, which is why the protein has been touted recently as a means to determine the relative risk of heart disease in some patients. Current recommendations for CRP testing use the same criteria to determine risk for everyone. However, one size might not fit all; there may be important differences between men and women and between people of different races.

Lead author Dr. Amit Khera, Assistant Professor of Internal Medicine, said:

"Our goal was to determine the distribution of CRP levels among different genders and races. CRP as a risk factor for cardiovascular disease has been studied mainly in white men and in research groups that do not necessarily represent the community at large. The recommended thresholds of CRP may not appropriately reflect CRP distributions for black men and women."

Researchers measured CRP levels in more than 2,700 men and women 30 to 65 years of age. Patients with a higher body mass index (BMI), a measurement of obesity, had correspondingly higher levels of CRP. Women typically had much higher serum levels of CRP than men, and African-Americans had higher levels of CRP than Caucasians. CRP levels in Caucasian women were also higher than those in African-American men, although these men had disproportionately higher rates of cardiovascular disease than Caucasian women.

Dr. Khera said that because Caucasian women have lower rates of cardiovascular disease, the study raised questions about how best to use CRP in the real-world setting. She added that more research is needed to determine whether these differences affect variations in cardiovascular events. She commented that it was possible that different thresholds would need to exist between men and women to more accurately determine the risk of heart disease. Relying on the CRP level for risk assessment in African-Americans might overestimate the risk of cardiac and vascular events, because more than half of these patients had elevated levels. Yet few studies have addressed CRP in African-American patients.

Senior author and Assistant Professor Dr. James de Lemos, said:

"This is a large study that highlights potentially important race and gender differences in CRP levels. The most striking finding was the observation that almost two-thirds of black women had CRP levels above the Centers for Disease Control-defined high-risk threshold. These differences may have implications for the broad use of CRP testing".

(Source: Journal of the American College of Cardiology, August 2005.)
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Publication:Nutrition Health Review
Date:Dec 22, 2011
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