Elevated CRP levels, red flag for cardiovascular problems

Pastures of Plenty

How will you control your CRP?

As most HSI members are now well aware, CRP is the acronym for C-reactive protein, which is produced in the liver in response to inflammation. And because atherosclerosis (narrowing of the arteries) requires inflammation to take place, elevated CRP is now considered a red flag for cardiovascular problems.

Over the past few years the importance of checking CRP levels has been steadily emerging on the medical mainstream radar. In fact, some in the mainstream have even observed (correctly) that CRP may be a more important marker for heart disease than LDL cholesterol.

Wait a minute. Why in the world would the mainstream rate the importance of CRP over LDL? After all, treating LDL with statin drugs has produced billions of dollars of revenue for drug company executives and their associates in the medical establishment. Why would they harm their cash cow?

The answer is simple: No harm done. The cash cow has found a new pasture to graze in.

Laying the groundwork

Last year I told you that researchers for AstraZeneca (AZ) were testing the effects of their controversial cholesterol-lowering statin drug Crestor on CRP. This study (still ongoing) is titled JUPITER (Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin).

And the title is revealing: “Justification for the use” It would seem that the desired conclusion of the study is already written. Now if the results will just cooperate and “justify” the use of statins, the study will provide AZ with a useful marketing tool.

Meanwhile, there are indications that the guys at AZ are barking up a money tree. In the e-Alert “Full of CRP” (2/17/05), I told you about two studies in the New England Journal of Medicine that both concluded that statin drugs may lower CRP. In fact, in one study CRP levels were cut by an impressive 36 percent with the use of statins.

The downside? That lowered CRP level was achieved with a high dose (80 mg) of Lipitor, the Big Kahuna of statin drugs. And as we’ve seen in previous e-Alerts, higher doses increase the chances of liver and muscle damage side effects.

Add a dash of C

I’ll give the drug companies this: At the very least, their campaigns to show the effectiveness of statins in controlling CRP has put this important heart health marker in the spotlight. What the drug companies won’t tell you is that statins are not required to address CRP. (After all, it’s not as if elevated CRP represents a statin deficiency.)

As I’ve mentioned in previous e-Alerts, exercise, weight loss and an intake of omega-3 fatty acids have all been associated with reduced levels of CRP. And last year, researchers from the University of California (UC), Berkeley, reported on a key study that examined the effects of antioxidant supplements on CRP levels.

The 160 subjects who participated in the study all had detectable CRP concentrations, but none had high levels and none were diagnosed with an acute illness. All of the subjects were smokers or were regularly exposed to second-hand smoke. Researchers divided the subjects into three groups; one group received 515 mg of vitamin C each day, one group received an antioxidant “cocktail” combining vitamin C, alpha-lipoic acid, and vitamin E (a mix of alpha-tocopherol, gamma-tocopherol and mixed tocotrienols), and a third group received a placebo.

Researchers took blood samples from each subject before the two-month supplementation period, and again when the test period was finished. Analysis of the samples showed that CRP levels rose slightly for those in the placebo group. Subjects who took the antioxidant mix experienced a small decrease in CRP (just under 5 percent). But in the vitamin C group, CRP dropped an average of nearly 25 percent.

Researchers couldn’t explain why the antioxidant mix had relatively little effect on CRP while the vitamin C alone had such a significant effect. But needless to say, if future studies confirm these findngs (which the UC team describes as the first of its kind), vitamin C supplements might eventually be considered part of a standard – and safe – protocol in addressing elevated CRP.

Blood work

The next time you have blood drawn at your doctor’s office, ask to have your CRP level measured. And don’t assume that CRP will automatically be included in the diagnostic breakdown. Some insurance companies still don’t include CRP testing as part of the standard array of tests, so you may have to pay a slight additional charge. I expect this will change as the importance of CRP becomes well known as a critical tool in assessing risk of chronic health problems.

In the meantime, if you want to try using a vitamin C supplement to help keep your CRP levels in line, HSI Panelist Allan Spreen, M.D., provides an excellent commentary on the pros and cons of the different types of vitamin C in the e-Alert “Attack of the Vapors” (1/6/04). You can easily find this in the e-Alert archives on our web site at hsionline.com.

Sources:
“Plasma C-Reactive Protein concentrations in Active and Passive Smokers: Influence of Antioxidant Supplementation” Journal of the American College of Nutrition, Vol. 23, No. 2, ncbi.nlm.nih.gov
“Vitamin C Supplement Could Cut Heart Disease and Diabetes” NutraIngredients.com, 4/14/04, nutraingredients.com
“Research Tests Statins on C-Reactive Protein” Internet Broadcasting Systems, 4/16/04, thewbalchannel.com
“Study to Determine the Effects of Statins and C-Reactive Protein on Cardiovascular Disease” Edelman Public Relations, March 2003, scienceblog.com