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Title: C-Reactive Protein, IL-6 Levels Tied to Heart Disease in Postmenopausal Women

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JAMA, 2002; 288: 980-987
08/28/2002 10:58:21 AM
By Elda Hauschildt

Baseline levels of the inflammatory biomarkers C-reactive protein (CRP) and interleukin-6 (IL-6) are independently associated with a two-fold increase in risk of healthy postmenopausal women developing coronary heart disease (CHD). While long-term use of hormone replacement therapy (HRT) is associated with increased CRP levels in postmenopausal women, it may not necessarily stimulate a generalised systemic laboratory response, United States researchers report. They also say that the odds ratios for incident CHD are similar among HRT users and non-users in analyses stratified by underlying levels of either CRP or IL-6. Investigators led by Dr. Aruna Pradhan of Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts, used data from the US national Women's Health Initiative Observational Study to assess the associations between baseline CRP, IL-6 and incident CHD. A total of 75,343 initially healthy, postmenopausal women made up the prospective cohort for the women's study. Participants had no history of cardiovascular disease or cancer at baseline. Investigators found 304 women developed incident CHD. These participants were matched by age, smoking status, ethnicity and follow-up time with 304 participants who remained event-free during median observation time of 2.9 years. Baseline CRP and IL-6 levels were found to be significantly higher in women who had coronary events compared with those who did not. When odds ratios were developed for incident CHD in the highest versus the lowest quartile, the ratios were found to be 2.3 for CRP and 3.3 for IL-6. The researchers note current HRT use, as expected, was associated with significantly elevated CRP levels. There was no association between HRT and IL-6. But when women with similar baseline CRP or IL-6 levels were compared, those taking HRT had similar CHD odds ratio as those not taking HRT. The investigators concluded: "These prospective data demonstrate that the inflammatory biomarkers CRP and IL-6 predict incident cardiovascular events in healthy postmenopausal women, an effect present among HRT users and non-users."

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