Association of C-reactive protein with markers of prevalent atherosclerotic disease

Recent prospective studies have demonstrated that elevated C-reactive prote in (CRP) is a marker of increased risk of atherothrombotic clinical events. We examined in a large, cross-sectional family-based study (n = 875 men, 9 48 women) whether serum CRP was associated with prevalent coronary heart di sease (CHD), the ankle/brachial blood pressure index, or carotid intima-med ia thickness, an indicator of subclinical atherosclerosis as assessed by B- mode ultrasound. CRP was associated with many other cardiovascular risk fac tors, particularly markers of obesity and insulin resistance, markers of in flammation and acute phase reaction, and hormone replacement therapy. Adjus ted for age and family type, there was a weak positive association of CRP w ith carotid intima-media thickness in both genders and with prevalent CHD i n women. However, adjustment for other risk factors completely eliminated t he associations. For example, among women, the risk factor-adjusted mean va lues of intima-media thickness across quartiles of CRP were 0.76, 0.74, 0.7 5, and 0.76 mm (p > 0.5). In men there was a weak inverse association betwe en CRP and ankle/brachical blood pressure index, independent of other risk factors, but no such association in women. Our findings indicate that CRP i s not strongly and independently associated with prevalent atherosclerosis. Because CRP has been associated with clinical events, it could be that ele vated CRP may be a stronger marker of thrombotic risk than of the degree of atherosclerosis. (C) 2001 by Excerpta Medica, Inc.