The powers of the predict a cholesterol test only go so far. If your LDL cholesterol is low, your C-reactive protein May a better sign of impending heart problems.
The knowledge gap between what is good for you and, indeed, it can be very large, especially when it comes to do something, as an exercise. (Never underestimate the attractiveness of the sedentary way of life.) Many of us need a warning, saying something occur in the pants before we change our ways, and heart-healthy program.
For decades, cholesterol test has this warning too much. A high degree of "bad" LDL cholesterol was just the warning of people took their opportunities to do so. He played this role for several reasons. People like the tests because the results seem objective. Measurement of cholesterol is simple and relatively cheap. It is logical, biologically. LDL cholesterol, a protein package contains fat and cholesterol, a tendency to drag and drop from the blood circulation and accommodation in the walls of blood vessels, the panel responsible for blood clotting and heart attacks.
Is it logically and statistically. The correlation between the decrease your LDL cholesterol and reduce your chances of developing a heart attack or other forms of heart disease is well documented. In fact, exercise and changes in diet good for the heart in part because they lower LDL cholesterol.
But for all their virtues, the tests of cholesterol contract has serious shortcomings. Research has shown that only about 50% of the population, heart attacks have high LDL. If the LDL should be an alarm signal, then it does not, of half of those for an alarm clock.
This gap has two problems. First, and obviously many people who are not respected. So there is a need for another test, "Fang", the fingers glide through the screening cholesterol.
Secondly, because the cholesterol screening as not to miss the beginning of a heart attack, he suggests that cholesterol does not adequately explain the heart.
Inflammation, it seems that the Declaration and the C-reactive protein (CRP), a byproduct of inflammation, May supply to the test. The experts investigate the blood vessels, the plate, and heart attacks were the smallest detail the development of an inflammatory statement, please. It describes a process, not unlike plumbers according clogged. The blood vessels are not fixed hoses, pipes, but thin layers, the living tissue, some very sensitive. LDL cholesterol is not limited to, in the arterial walls to the injured. And injuries as elsewhere in the body, the result is an inflammation response. The swarms of cytokines, the macrophages, cells and other customs melts you zoom in and around the deposits of LDL-cholesterol in the accumulation of fatty foam cells for the fiber sealing cap for the collagen.
Other inflammatory molecules can soften and a fibrous cap that he finally explodes open. The content of the introductory panel and activate the clotting factor in blood. A massive blood clot forms. The result: an artery and a heart attack.
If the inflammation explained that the heart attacks and then a test with which to measure inflammatory activity doctors within the blood vessels could be valuable. CRP is nothing new to medical science. Protein was discovered more than 70 years.
The researchers have quickly understood that this is part of the immune or inflammatory response, because the increase in response to an infection by Streptococcus. In fact, the doctors have CRP measures for the coming decades to patients with lupus, rheumatoid arthritis and other conditions associated with the immune system. But as a way to screen for diseases of the heart? That was a different story. All the momentum and a large part of the science used to test for cholesterol. Today, however, the tests CRP seems ready, for several reasons.
The people have heard or read about the reasoning behind them. The inflammatory statement of atherosclerosis and heart attacks rarely has an impact on the search for doctors and the public. Dozens of newspapers, magazines, newsletters and articles have been written on this topic. People are more of a test, and perhaps even a request if they have a certain understanding of what is measured and why. This also applies to physicians.
It is a good predictor of diseases of the heart. Even if the heart attacks were by inflammation, the CRP tests are not useful unless it has turned out to be a good predictor. In other words, the studies have shown that there is a strong correlation between high C-reactive protein and the chances of a heart attack. To ensure a long story short, it is fair, which is a series of studies published in the prestigious magazine showed. One in the 14th Nov. 2002, New England Journal of Medicine, came to the conclusion that CRP exceeds LDL cholesterol as a predictor of cardiovascular risk. Furthermore, the authors found that the two tests the various groups with high risk, with the two is better than one. (If you are interested in the details of this CRP and other studies, please visit our Web site http://www.health.harvard.edu/health.) There is a better predictor than other measures of inflammation. There are other methods to measure inflammation. But a study in the March 23, 2000, New England Journal of Medicine concluded that the C-reactive protein is a better predictor of cardiovascular events (heart attack, stroke, the Coronary artery bypass or angioplasty) that the marker other inflammatory diseases .
There is a distinction between capital and lowercase letters. Until relatively recently, the test available can not reliably measure low (less than 10 milligrams per liter) on CRP. The tests are now sufficient for the measurement of 1 mg / l or less. It is a crucial element of development, because it is relatively small deviations from the lo w, that the cardiovascular risk. The test costs $ 12 - $ 16, and it takes only a small amount of blood. In fact, even blood samples are sent to a laboratory for both cholesterol and C-reactive protein tests.
Thresholds without preselection, the doctors do not know how to interpret the results of the tests CRP. Dr. Paul Ratpick, a researcher at Harvard scientists, in most trials decisive, CRP, and it is about co-patents. He says he is now possible to the classification of CRP in view of the low, medium or high risk. Less than 1 milligram per liter of blood is a low risk for heart attack or other cardiovascular problems, 1.3 milligrams per liter is a medium-risk, and more than 3 mg, with a high risk. These thresholds may change with the research (such as those who cholesterol), but they are a starting point.
Imagine that your doctor will tell you that newfangled examination of the inflammation shows that a worrying extent of a witness of proteins, but, uh, there's not much you or they can on this issue. There would be no People's Party or the attempt sense, even if it is a perfect prognosticator heart attacks.
A large part because of the growing enthusiasm for the C-reactive protein test is that the levels are reduced. The statin drugs (Lipitor, Zocor, other brands) have their names through the reduction of LDL, research has shown that they also C-reactive protein level. The exercise is a great way, after you click CRP, weight loss seems even at work.
C-reactive protein "hawks" of the view that the time has come where everyone has the test and May before the final tests of cholesterol. "Doves" to say that it is simply not enough evidence, like the doctors in the treatment should be high, even if it's a combination of cardiovascular risk.
Since we went in the press (2003), and the American Heart Association (AHA) and the American College of Cardiology has made a formal recommendation on C-reactive protein. Published comments from executives AHA suspicion that game on a practice area and proposed persons, in an intermediary group in danger because of their age (60 years and older), the weight or blood pressure. AHA and other guidelines have an influence on how doctors use the CRP test in the next year. Ultimately, however, is the fate of the test for prospective, randomized trials of CRP reduction interventions still underway.
Dr. Ratpick study from November 2002 compared C-reactive protein and LDL was found that the cardiovascular risk was in fact more for the people in the CRP above or below LDL group as well as for the low CRP / high LDL Group. It is clear that the tests of cholesterol is not found in the human CRP above or below LDL group.
If these results are to sit the tests CRP may be desirable to people with low LDL. Because the test is cheap, may depend on doctors for the two trials, from the outset than to wait until the results of cholesterol.
No test, no matter how good it is, the changes in the health sector to take. We do this in response to questions. Statins have a pharmaceutical product on the face of preventing heart disease, but the old truths about the acquisition of the fiscal year, the right to eat, smoke and do not always hold. If the test is successful CRP more people in this Council, then it is helpful May. |
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