This article is more than 5 years old. Information may no longer be current.
Higher levels of CRP linked to elevated CAC levels in black women
Middle-aged black women with coronary artery calcification had nearly double the level of C-reactive protein in their blood than white women with similar amounts of atherosclerotic plaque, researchers reported in Menopause.
This finding, the researchers said in a press release, suggests that routine testing for high-sensitivity CRP in black menopausal women may help screen for heart disease, although current American College of Cardiology Foundation/American Heart Association guidelines for CVD risk assessment do not recommend selective assessment by race or ethnicity.
“Our study revealed for the first time that in black, but not white, women going through menopause, higher levels of an easily measured risk factor for heart disease are associated with higher amounts of early atherosclerosis, even after accounting for other risk factors for heart disease,” Norman C. Wang, MD, MS, an assistant professor of medicine at the University of Pittsburgh Graduate School of Public Health, said in the release. “A clinical trial to determine whether routine screening in this population can save lives may be warranted.”
Using data from the Study of Women’s Health Across the Nation, the researchers assessed the relationship between five biomarkers (CRP, fibrinogen, plasminogen activator inhibitor type 1, tissue plasminogen activator antigen and Factor VIIc) and coronary artery calcification (CAC) presence and extent in 372 menopausal women (mean age, 51.3 years; 35.2% black). Most of the participants had a CAC score between 0 and 100, and those with CAC were more likely to have a worse CHD risk profile than participants without any calcification.
Link found in black women
All five biomarkers were associated with CAC presence and extent (P < .0001 for all), even after adjusting for potential confounders such as Framingham risk score, race/ethnicity, menopause status, income and education. However, after adjusting for BMI, the biomarker that remained independently associated was Factor VIIc, but only to CAC extent (P = .002).
In both univariable and multivariable models, the relationship between high-sensitivity CRP and CAC presence and extent varied depending on race/ethnicity (P < .05). Compared with women with no CAC, both white and black women with CAC had higher levels of high-sensitivity CRP; however, the median level was higher among black women (P = .002), and in the final model, high-sensitivity CRP was only found to be independently associated with CAC presence (OR = 3.25; 95% CI, 1.53-6.9; P = .002; per 1 log unit increase) and CAC extent (beta = 19.66; standard error = 7.67; P = .01; per 1 log unit increase) in black women.
Combatting obesity
“We clearly demonstrated that obesity, inflammation biomarkers and [CAC] are linked for both black and white midlife women, further emphasizing the need to promote lifestyle changes to combat obesity at midlife when women are subjected to many physiological and biological changes that could potentially increase their risk for heart disease,” Samar El Khoudary, PhD, MPH, assistant professor of epidemiology at the University of Pittsburgh Graduate School of Public Health, said in the release.
“Future research should build on our findings regarding black women and [CRP] by testing similar associations over time, which could potentially yield interventions that can help these women avoid developing heart disease,” El Khoudary said.
The researchers said in the release that because their study only included black and white women, the findings are not generalizable to other racial or ethnic groups. – by Tracey Romero
D isclosure: The study was funded by the NIH. The researchers report no relevant financial disclosures.