DOES HIGH CRP CAUSE HEART DISEASE?

DOES HIGH CRP LEVELS CAUSE HEART DISEASE?

The Jupiter study on statins has carved out a new class of people that could be helped by cholesterol drugs.  They don’t get them because their cholesterol levels are normal.  The study can’t say why the anti-  cholesterol drug Crestor helped those in the study who had elevated CRP levels.

The 9000 people in the study who took Crestor had their CRP lowered by 32% and the bad LDL lowered by 50%.  Heart attacks and strokes were 50% lower than in the placebo group.  At least some of the benefit was due to the lowering of CRP levels.  The manufacturer can’t explain why.

Is CRP a heart risk indicator?  CRP is a nonspecific, and it is up in several diseases.  It is a marker for not being healthy.  By focusing on this inflammation, they think they are catching people under the radar screen.

Were they really treating high CRP levels?  The study people had normal cholesterols, but most were overweight, 15% were smokers and 40% had metabolic syndrome.  All these factors are known to raise CRP levels.  If you have normal cholesterol and some risk factors high blood pressure, or obesity, should you be treated to get your cholesterol even lower? 

Does CRP levels actually cause disease?  Did the great results occur because the drug lowered the CRP?   Most doubt this because of a study of 50,000 Danes, who had their DNA studies.  It showed such variations in the CRP gene that they concluded the gene doesn’t cause heart disease nor does the protein. (NEJM Oct.30. 2008).

It seems CRP is a consequence, not a cause, of atherosclerosis.  The cholesterol penetrates the artery walls and white blood cells come to remove it.  This causes inflammation and raises CRP.  Hence, the high CRP levels indicate atherosclerosis that might not show symptoms.  CRP is not a driving force in heart disease.

Putting millions of low risk patients on medication for the rest of their lives raises the cost risk value of such a prevention program.  The patients were studied for just under 2 years.  The LDL plunged to a very low 55. Since plaque formation occurs with high LDL levels, it makes sense that reducing the LDL might prevent the disease   Muscle cramps and muscle weakness occurred in 1352 people on the drug.  The group had 270 diabetics and 216 placebos.  The FDA will probably approve the drug use in 2010. 

Controlling cholesterol is gospel in heart medicine.  It guides treatment, and sell billions of dollars in drugs.  We all are told bad cholesterol, LDL causes heart attacks and good cholesterol HDL, is protective.  But why do people with great cholesterol levels still suffer heart attacks?

The Jupiter study recruited only people with healthy LDL levels of 100 average.  The bottom line is does taking the drug preserve health?  Isis Drug Company is already developing a CRP inhibitor and is testing it in healthy volunteers.

                  Source:    Science Nov. 14, 2008

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