Association between C-reactive protein and mortality

COPENHAGEN, DENMARK. There is substantial evidence that atrial fibrillation (AF) is associated with an increased level of the inflammation biomarker C-reactive protein (CRP). It is, however, not clear whether inflammation causes AF or AF causes the inflammation indicated by an elevated CRP level. Danish researchers now report that an elevated CRP level also is closely associated with an increase in overall mortality.

Their study, the Copenhagen City Heart Study, enrolled 10,388 persons from the general population in the years 1991 to 1994. All participants underwent extensive blood testing at entry and were then followed for 16 years during which 3124 participants (30%) died. Participants that died were more likely to be men, elderly, smokers or suffering from diabetes or hypertension.

The researchers also noted that an elevated CRP level at baseline was a strong risk factor for early death. Participants with a CRP level exceeding 3.0 mg/L (0.3 mg/dL) were twice as likely to die prematurely than were those with a CRP level below 1.0 mg/L (0.1 mg/dL). A high CRP level was associated primarily with an increase in cardiovascular death, but an association with cancer-related deaths, and indeed death from any cause, was also noted. No association between CRP level and mortality was found for individuals whose CRP level was permanently elevated because of a genetic mutation (polymorphism).

This finding caused the researchers to conclude that, while there is a clear association between elevated CRP and mortality, this is not due to the fact that CRP as such increases mortality, but rather due to the underlying inflammation revealed by the increase in CRP.

Zacho, J, et al. C-reactive protein and all-cause mortality. European Heart Journal, Vol. 31, 2010, pp. 1624-32

Editorís comment: The Danish study confirms that inflammation is a strong risk factor for early death. Thus it would seem prudent for everyone with an elevated CRP level to take steps to eliminate the inflammation causing the increase in CRP. Apart from cutting out obvious inflammation triggers such as alcohol and caffeine, it would also be prudent to refrain from vigorous exercise and workouts until the inflammation has subsided. Supplementation with natural anti-inflammatories such as Moducare, curcumin, beta-sitosterol or Zyflamend is also an essential step in eliminating systemic inflammation and reducing CRP level.