PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of bmjLink to Publisher's site
 
BMJ. 1996 April 27; 312(7038): 1061–1065.
PMCID: PMC2350910

C reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study.

Abstract

OBJECTIVE--To test the hypothesis that minor chronic insults such as smoking, chronic bronchitis, and two persistent bacterial infections may be associated with increases in C reactive protein concentration within the normal range and that variations in the C reactive protein concentration in turn may be associated with levels of cardiovascular risk factors and chronic coronary heart disease. DESIGN--Population based cross sectional study. SETTING--General practices in Merton, Sutton, and Wandsworth. SUBJECTS--A random sample of 388 men aged 50-69 years from general practice registers. 612 men were invited to attend and 413 attended, of whom 25 non-white men were excluded. The first 303 of the remaining 388 men had full risk factor profiles determined. INTERVENTIONS--Measurements of serum C reactive protein concentrations by in house enzyme linked immunosorbent assay (ELISA); other determinations by standard methods. Coronary heart disease was sought by the Rose angina questionnaire and Minnesota coded electrocardiograms. MAIN OUTCOME MEASURES--Serum C reactive protein concentrations, cardiovascular risk factor levels, and the presence of coronary heart disease. RESULTS--Increasing age, smoking, symptoms of chronic bronchitis, Helicobacter pylori and Chlamydia pneumoniae infections, and body mass index were all associated with raised concentrations of C reactive protein. C Reactive protein concentration was associated with raised serum fibrinogen, sialic acid, total cholesterol, triglyceride, glucose, and apolipoprotein B values. C Reactive protein concentration was negatively associated with high density lipoprotein cholesterol concentration. There was a weaker positive relation with low density lipoprotein cholesterol concentration and no relation with apolipoprotein A I value. C Reactive protein concentration was also strongly associated with coronary heart disease. CONCLUSION--The body's response to inflammation may play an important part in influencing the progression of atherosclerosis. The association of C reactive protein concentration with coronary heart disease needs testing in prospective studies.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Fahie-Wilson M, Mills R, Wilson K. HDL cholesterol and the acute phase reaction following myocardial infarction and acute pancreatitis. Clin Chim Acta. 1987 Aug 14;167(2):197–209. [PubMed]
  • Alvarez C, Ramos A. Lipids, lipoproteins, and apoproteins in serum during infection. Clin Chem. 1986 Jan;32(1 Pt 1):142–145. [PubMed]
  • Heldenberg D, Rubinstein A, Levtov O, Berns L, Werbin B, Tamir I. Serum lipids and lipoprotein concentrations during the acute phase of myocardial infarction. Atherosclerosis. 1980 Apr;35(4):433–437. [PubMed]
  • Ryder RE, Hayes TM, Mulligan IP, Kingswood JC, Williams S, Owens DR. How soon after myocardial infarction should plasma lipid values be assessed? Br Med J (Clin Res Ed) 1984 Dec 15;289(6459):1651–1653. [PMC free article] [PubMed]
  • Coombes EJ, Shakespeare PG, Batstone GF. Lipoprotein changes after burn injury in man. J Trauma. 1980 Nov;20(11):971–975. [PubMed]
  • Cabana VG, Siegel JN, Sabesin SM. Effects of the acute phase response on the concentration and density distribution of plasma lipids and apolipoproteins. J Lipid Res. 1989 Jan;30(1):39–49. [PubMed]
  • Lindberg G, Eklund GA, Gullberg B, Råstam L. Serum sialic acid concentration and cardiovascular mortality. BMJ. 1991 Jan 19;302(6769):143–146. [PMC free article] [PubMed]
  • Steel DM, Whitehead AS. The major acute phase reactants: C-reactive protein, serum amyloid P component and serum amyloid A protein. Immunol Today. 1994 Feb;15(2):81–88. [PubMed]
  • Wiklund I, Lindvall K, Swedberg K. Assessment of quality of life in clinical trials. Acta Med Scand. 1986;220(1):1–3. [PubMed]
  • Wakhweya AM. Structural adjustment and health. BMJ. 1995 Jul 8;311(6997):71–72. [PMC free article] [PubMed]
  • Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesäniemi YA, Syrjälä SL, Jungell PS, Isoluoma M, Hietaniemi K, Jokinen MJ. Association between dental health and acute myocardial infarction. BMJ. 1989 Mar 25;298(6676):779–781. [PMC free article] [PubMed]
  • Mendall MA, Goggin PM, Molineaux N, Levy J, Toosy T, Strachan D, Camm AJ, Northfield TC. Relation of Helicobacter pylori infection and coronary heart disease. Br Heart J. 1994 May;71(5):437–439. [PMC free article] [PubMed]
  • Saikku P, Leinonen M, Tenkanen L, Linnanmäki E, Ekman MR, Manninen V, Mänttäri M, Frick MH, Huttunen JK. Chronic Chlamydia pneumoniae infection as a risk factor for coronary heart disease in the Helsinki Heart Study. Ann Intern Med. 1992 Feb 15;116(4):273–278. [PubMed]
  • Woodhouse PR, Khaw KT, Plummer M, Foley A, Meade TW. Seasonal variations of plasma fibrinogen and factor VII activity in the elderly: winter infections and death from cardiovascular disease. Lancet. 1994 Feb 19;343(8895):435–439. [PubMed]
  • Juhan-Vague I, Thompson SG, Jespersen J. Involvement of the hemostatic system in the insulin resistance syndrome. A study of 1500 patients with angina pectoris. The ECAT Angina Pectoris Study Group. Arterioscler Thromb. 1993 Dec;13(12):1865–1873. [PubMed]
  • Liuzzo G, Biasucci LM, Gallimore JR, Grillo RL, Rebuzzi AG, Pepys MB, Maseri A. The prognostic value of C-reactive protein and serum amyloid a protein in severe unstable angina. N Engl J Med. 1994 Aug 18;331(7):417–424. [PubMed]
  • Thompson SG, Kienast J, Pyke SD, Haverkate F, van de Loo JC. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. N Engl J Med. 1995 Mar 9;332(10):635–641. [PubMed]
  • Gauldie J, Richards C, Northemann W, Fey G, Baumann H. IFN beta 2/BSF2/IL-6 is the monocyte-derived HSF that regulates receptor-specific acute phase gene regulation in hepatocytes. Ann N Y Acad Sci. 1989;557:46–59. [PubMed]
  • Mackiewicz A, Speroff T, Ganapathi MK, Kushner I. Effects of cytokine combinations on acute phase protein production in two human hepatoma cell lines. J Immunol. 1991 May 1;146(9):3032–3037. [PubMed]
  • Baumann H, Gauldie J. The acute phase response. Immunol Today. 1994 Feb;15(2):74–80. [PubMed]
  • Hotamisligil GS, Arner P, Caro JF, Atkinson RL, Spiegelman BM. Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. J Clin Invest. 1995 May;95(5):2409–2415. [PMC free article] [PubMed]
  • Naito HK. Serum apolipoprotein measurements: an improved discriminator for assessing coronary heart disease risk. Compr Ther. 1987 Nov;13(11):43–52. [PubMed]
  • Feingold KR, Grunfeld C. Role of cytokines in inducing hyperlipidemia. Diabetes. 1992 Oct;41 (Suppl 2):97–101. [PubMed]
  • Akira S, Taga T, Kishimoto T. Interleukin-6 in biology and medicine. Adv Immunol. 1993;54:1–78. [PubMed]
  • Kahn CR. Diabetes. Causes of insulin resistance. Nature. 1995 Feb 2;373(6513):384–385. [PubMed]
  • Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988 Dec;37(12):1595–1607. [PubMed]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Group