Relationship of C-Reactive Protein to Risk of Cardiovascular Disease in the Elderly
- 1 June 1997
- journal article
- research article
- Published by Wolters Kluwer Health in Arteriosclerosis, Thrombosis, and Vascular Biology
- Vol. 17 (6) , 1121-1127
- https://doi.org/10.1161/01.atv.17.6.1121
Abstract
Markers of inflammation, such as C-reactive protein (CRP), are related to risk of cardiovascular disease (CVD) events in those with angina, but little is known about individuals without prevalent clinical CVD. We performed a prospective, nested case-control study in the Cardiovascular Health Study (CHS; 5201 healthy elderly men and women). Case subjects (n=146 men and women with incident CVD events including angina, myocardial infarction, and death) and control subjects (n=146) were matched on the basis of sex and the presence or absence of significant subclinical CVD at baseline (average follow-up, 2.4 years). In women but not men, the mean CRP level was higher for case subjects than for control subjects (P≤.05). In general, CRP was higher in those with subclinical disease. Most of the association of CRP with female case subjects versus control subjects was in the subgroup with subclinical disease: 3.33 versus 1.90 mg/L, P<.05, adjusted for age and time of follow-up. Case-control differences were greatest when the time between baseline and the CVD event was shortest. The strongest associations were with myocardial infarction, and there was an overall odds ratio for incident myocardial infarction for men and women with subclinical disease (upper quartile versus lower three quartiles) of 2.67 (confidence interval [CI]=1.04 to 6.81), with the relationship being stronger in women (4.50 [CI=0.97 to 20.8]) than in men (1.75 [CI=0.51 to 5.98]). We performed a similar study in the Rural Health Promotion Project, in which mean values of CRP were higher for female case subjects than for female control subjects, but no differences were apparent for men. Comparing the upper quintile with the lower four, the odds ratio for CVD case subjects was 2.7 (CI=1.10 to 6.60). In conclusion, CRP was associated with incident events in the elderly, especially in those with subclinical disease at baseline.Keywords
This publication has 30 references indexed in Scilit:
- Methods of assessing prevalent cardiovascular disease in the Cardiovascular Health StudyAnnals of Epidemiology, 1995
- Importance of Smoking for Chlamydia pneumoniae SeropositivityInternational Journal of Epidemiology, 1994
- Fibrinogen: a link between chronic infection and coronary heart diseaseThe Lancet, 1994
- Triggers, acute risk factors and vulnerable plaques: The lexicon of a new frontierJournal of the American College of Cardiology, 1994
- Comparison of recruitment strategies and associated disease prevalence for health promotion in rural elderlyPreventive Medicine, 1992
- The Pathogenesis of Coronary Artery Disease and the Acute Coronary SyndromesNew England Journal of Medicine, 1992
- The Pathogenesis of Coronary Artery Disease and the Acute Coronary SyndromesNew England Journal of Medicine, 1992
- The cardiovascular health study: Design and rationaleAnnals of Epidemiology, 1991
- C-reactive protein: A critical reviewPathology, 1991
- HAEMOSTATIC FUNCTION AND ISCHAEMIC HEART DISEASE: PRINCIPAL RESULTS OF THE NORTHWICK PARK HEART STUDYThe Lancet, 1986