The Savvy Senior — Heart attack indicators go beyond cholesterol
February 28, 2003
Dear Savvy Senior — Have you heard of a new study out that basically says cholesterol tests are not a good indicator of heart attack and stroke danger? I don’t know where it came from but I find this news very alarming. My father died of a heart attack at age 56 and my mother suffered from high blood pressure much of her life, so my clogged genetic history tells me to look out. If a cholesterol test isn’t a good measuring stick for us hypertensive old folks, what is?
Serious As A Heart Attack
Dear Serious — According to a new savvy study cholesterol tests aren’t necessarily bad measuring sticks. They just don’t tell you the whole savvy story. New studies show that simmering, painless inflammation deep within the body is the single most powerful trigger of heart attacks, worse even than high cholesterol.
Savvy Study: Published in the New England Journal of Medicine, the study followed almost 28,000 women for eight years. Fully 77 percent of those who had heart attacks or strokes had cholesterol in the normal range and 45 percent were in the ideal range. Not good!
The study also included a separate blood test that measures something called C-reactive protein or CRP, a measure of inflammation deep within the body. The study found that the CRP test actually did a better job of predicting heart disease risk than cholesterol. Those with high levels of inflammation are twice as likely as those with high cholesterol to die from heart attacks and strokes.
Savvy Note: The two tests did the best job of all, said study author Dr. Paul Ridker of Brigham and Women’s Hospital in Boston. In other words, individuals who have both these abnormalities are at very high risk. Individuals without either of them have relatively low risk.
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Savvy Hypothesis: With Ridker’s latest study, many believe the evidence is overwhelming that inflammation is a central factor in cardiovascular disease. Doctors believe inflammation has many possible sources. Often, the fatty build-ups that line the blood vessels become inflamed as white blood cells invade in a misguided defense attempt. Fat cells are also known to turn out these inflammatory proteins. Other possible triggers include high blood pressure, smoking and lingering low-level infections, such as chronic gum disease.
Inflammation is thought to weaken the fatty build-ups or plaques making them more likely to burst. A piece of plaque can then lead to a clot that can choke off the blood flow and cause a heart attack.
Savvy CRP Test: Experts are still divided over which patients to test and how to treat them if their CRP readings are high. Talk to your doctor or pharmacist about the CRP blood test.
Savvy Note: A CRP test can be tricky. It can jump as much as 10-fold when a person is fighting a cold or flu and it shouldn’t be used in place of a cholesterol test.
Savvy Tips to Lower Inflammation Levels:
— Responsibility and exercise. Inactivity and obesity increase inflammatory proteins of these proteins simply by improving their living habits.
— Moderate consumption of alcohol and fish oil.
— Not smoking and keeping blood pressure under control.
— A variety of drugs may also do the trick, though many thank more research is needed before doctors actually begin prescribing them to lower inflammation.
— Cholesterol-lowering drugs called statins can reduce the inflammation and do does a daily dose of aspirin. Check with your doctor first.
— U.S. Department of Health and Human Services — National Institutes of Health: http://www.nih.gov.
— American Heart Association: http://www.americanheart.org.
— The Centers for Disease Control and Prevention: http://www.cdc.gov.
Send your senior questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070 or visit the Web site at http://www.savvysenior.org.