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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
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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“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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Metadata
- 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
- Venue
- Circulation
- Published
- 2005-07-05
- Volume
- 112
- Issue
- 1
- Pages
- 25-31
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- 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 › Cardiology and Cardiovascular Medicine › 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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