C-Reactive Protein and the 10-Year Incidence of Coronary Heart Disease in Older Men and Women: The Cardiovascular Health Study

Cushman, Mary; Arnold, Alice M.; Psaty, Bruce M.; Manolio, Teri A.; Kuller, Lewis H.; Burke, Gregory L.; Polak, Joseph F.; Tracy, Russell P.

doi:10.1161/circulationaha.104.504159

Cited by 368Lipoproteins and Cardiovascular HealthInflammatory Biomarkers in Disease PrognosisCardiovascular Health and Risk Factors

C-Reactive Protein and the 10-Year Incidence of Coronary Heart Disease in Older Men and Women: The Cardiovascular Health Study

Cushman, Mary, Arnold, Alice M., Psaty, Bruce M., Manolio, Teri A., Kuller, Lewis H., Burke, Gregory L., Polak, Joseph F., Tracy, Russell P.·2005·Circulation

DOI 10.1161/circulationaha.104.504159

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Abstract

Background— High C-reactive protein (CRP) is associated with increased coronary heart disease risk. Few long-term data in the elderly are available. Methods and Results— Baseline CRP was measured in 3971 men and women ≥65 years of age without prior vascular diseases; 26% had elevated concentrations (>3 mg/L). With 10 years of follow-up, 547 participants developed coronary heart disease (CHD; defined as myocardial infarction or coronary death). With elevated CRP, the 10-year cumulative CHD incidences were 33% in men and 17% in women. The age-, ethnicity-, and sex-adjusted relative risk of CHD for CRP >3 mg/L compared with <1 mg/L was 1.82 (95% CI, 1.46 to 2.28). Adjusting for conventional risk factors reduced the relative risk to 1.45 (95% CI, 1.14 to 1.86). The population-attributable risk of CHD for elevated CRP was 11%. Risk relationships did not differ in subgroups defined by baseline risk factors. We assessed whether CRP improved prediction by the Framingham Risk Score. Among men with a 10-year Framingham-predicted risk of 10% to 20%, the observed CHD incidence was 32% for elevated CRP. Among women, CRP discriminated best among those with a 10-year predicted risk >20%; the incidences were 31% and 10% for elevated and normal CRP levels, respectively. Conclusions— In older men and women, elevated CRP was associated with increased 10-year risk of CHD, regardless of the presence or absence of cardiac risk factors. A single CRP measurement provided information beyond conventional risk assessment, especially in intermediate-Framingham-risk men and high-Framingham-risk women.

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High blood levels of high-sensitivity CRP and IL-6 predict cardiovascular disease risk in middle-aged and older adults, independent of other CVD risk factors.
“longitudinal studies demonstrate that high blood levels of pro-inflammatory markers, including high-sensitivity CRP assay and IL-6, predict the risk of cardiovascular disease in both middle-aged and older adults, independent of other CVD risk factors”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [159]

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Authors: Cushman, M., Arnold, A. M., Psaty, B. M., Manolio, T. A., Kuller, L. H., Burke, G. L., Polak, J. F., & Tracy, R. P.
Affiliations: University of Vermont (US)
ORCID: Cushman, Mary
Arnold, Alice M.
Psaty, Bruce M.
Manolio, Teri A.
Kuller, Lewis H.
Burke, Gregory L.
Polak, Joseph F.
Tracy, Russell P.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2005-07-05
Volume: 112
Issue: 1
Pages: 25-31
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.104.504159
OpenAlex: W2063058274
Cited by: 368
References: 40
Citations by year: 2026: 3 · 2025: 10 · 2024: 13 · 2023: 5 · 2022: 11 · 2021: 16 · 2020: 11 · 2019: 8 · 2018: 12 · 2017: 9 · 2016: 11 · 2015: 15 · 2014: 18 · 2013: 16 · 2012: 19
FWCI: 34.87
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (n01hc085079-024, n01hc015103-009, 5k08hl003618-05, n01hc085086-022, n01hc035129-010, N01HC85086, N01HC85079, N01HC-35129)
National Heart, Lung, and Blood Institute (R01HL046696, N01HC15103, HL03618, N01 HC85086, HL46696, HL-8329, N01-HC85079, N01HC35129)
Topics: Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords: C-reactive protein, coronary artery disease, myocardial infarction, coronary death, older adults, cardiovascular risk prediction, Framingham risk score, population attributable risk, sex differences
MeSH terms: Age Factors, Aged, Aged, 80 and over, C-Reactive Protein, Coronary Disease, Female, Humans, Inflammation, Male, Myocardial Infarction, Predictive Value of Tests, Risk Factors, Biomarkers, Incidence

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C-Reactive Protein and the 10-Year Incidence of Coronary Heart Disease in Older Men and Women: The Cardiovascular Health Study

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