C Reactive protein and its relation to cardiovascular risk factors: a population based cross sectional studyBMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7038.1061 (Published 27 April 1996) Cite this as: BMJ 1996;312:1061
- M A Mendall, senior lecturera,
- Praful Patel, research fellowa,
- Lydia Ballam, research assistanta,
- D Strachan, senior lecturerb,
- T C Northfield, professora
- a Division of Biochemical Medicine, St George's Medical School, London SW17 0RE
- b Public Health Sciences, St George's Medical School, London SW17 0RE
- Correspondence to: Dr Mendall.
- Accepted 13 February 1996
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.
Factors that determine levels of inflammatory mediators in the normal general population have not been explored, nor has their relation to cardio- vascular risk factors
Among 50-69 year old men many environmental and lifestyle risk factors for cardiovascular disease are associated with raised serum concentrations of C reactive protein
Circulating concentrations of lipids, glucose, and clotting factors are also associated with serum C reactive protein concentrations
The body's response to inflammation may influence the development of atherosclerosis
Funding British Heart Foundation.
Conflict of interest None.
- Accepted 13 February 1996