C-Reactive Protein, Inflammatory Conditions, and Cardiovascular Disease Risk

C-Reactive Protein, Inflammatory Conditions, and Cardiovascular Disease Risk

American Journal of Medicine.

Volume 120, Issue 12, Pages 1054-1062 (December 2007)


Ravi Dhingra, MDabc, Philimon Gona, PhDad, Byung-Ho Nam, PhDad, Ralph B. D’Agostino Sr, PhDad, Peter W.F. Wilson, MDae, Emelia J. Benjamin, MD, MSaf, Christopher J. O’Donnell, MD, MPHagh


Abstract

Background
It is uncertain to what extent high C-reactive protein (CRP) concentrations reflect the presence of inflammatory conditions in the community.

Methods
We evaluated 3782 Framingham Offspring Study participants (mean age 55 years; 52% women) free of baseline cardiovascular disease. Logistic regression models examined the prevalence of common inflammatory conditions by CRP categories, while a separate matched case-referent analysis evaluated the prevalence of uncommon inflammatory conditions. Cox models were used to assess the influence of common inflammatory conditions on relations between CRP and incident cardiovascular disease.

Results
Common inflammatory conditions were reported by nearly half of the participants; these individuals were more likely to have markedly high CRP concentrations (>10 mg/L, P for trend=.001). In multivariable models, there were increased odds of having at least one common inflammatory condition with CRP concentrations of 1-3.0, 3.01-10, and >10 mg/L, compared with the referent category (<1>10 mg/L compared with those with CRP <1 mg/L (12.1% vs 6.6%; P=.0001). In multivariable models, higher CRP categories were not associated with incident cardiovascular disease, and with additional adjustment for inflammatory conditions, results remained unchanged.

Conclusion
There is high prevalence of common and uncommon inflammatory conditions in individuals with high CRP concentrations. Higher CRP concentrations should be interpreted with caution in cardiovascular disease risk assessment