In The News: A New Affair Of The Heart

We all know that it's important to keep cholesterol under control. But the dirty little secret of cardiology is that more than half the people who suffer heart attacks have normal cholesterol levels. So how do you know if you're at risk? A simple test may help, according to a major study published last week in The New England Journal of Medicine.

Harvard cardiologist Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital, tested nearly 28,000 women for both LDL ("bad") cholesterol and blood levels of a substance called C-reactive protein, or CRP, an indicator of arterial inflammation. After eight years, he tallied up heart attacks and strokes among the women. Adjusting for risk factors like smoking and diabetes, he found that high cholesterol increased the women's heart-attack risk up to 1.5 times--but high CRP (more than 3 milligrams per liter of blood) increased it as much as 2.3 times.

That doesn't mean you should forget about cholesterol testing. In this study, the two tests often identified different high-risk individuals, so both tests seem to be important. The best outcome, of course, is to score low on both tests--the worst, high on both. But as the new study shows, normal and even low cholesterol readings are no guarantee of heart health if CRP is high. The American Heart Association is expected to issue guidelines for CRP testing within several months. In the meantime, use common sense and get some exercise, lose excess weight and stop smoking. That can help lower CRP and reduce heart-disease risk at the same time.