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The primary causes of cardiovascular disease have been identified as high blood cholesterol, high blood pressure, smoking and diabetes. However, even people without these risk factors may develop cardiovascular disease and researchers are beginning to understand what other risk factors may trigger cardiovascular disease. The new risk factors include C-reactive protein (CRP), Homocysteine, Fibrinogen and Lipoprotein (a). Not much is known about how these risk factors are linked to cardiovascular disease, or even how to measure them in a standardized manner but researchers feel it is worthwhile to learn more about these substances and how they relate to cardiovascular disease. They may provide a new avenue for treatment or diagnosis of the disease. CRP is known as an inflammatory marker because it is produced by the immune system when an injury or infection has occurred. Atherosclerosis is characterized by inflammation. Higher CRP levels have been linked with an increased risk of cardiovascular disease. For example, on study shows that women with high CRP levels face a seven times greater risk of heart attack or stroke than those with a low level. CRP is considered by some to be a better predictor of heart disease risk than cholesterol level whereas others consider it of little use at all. One of the difficulties in using CRP measurements to diagnose heart disease risk is that conditions such as rheumatoid arthritis, urinary tract infection, medications and obesity may also increase CRP levels. Currently, CRP level testing is only recommended for people with an intermediate risk of heart disease so that the level of treatment required can be better evaluated. Homocysteine is an amino acid used to build protein but high levels of the substance in the blood has been linked to increased risk of stroke, some type of heart disease and peripheral vascular disease. If high levels of homocysteine are combined with smoking and high blood pressure, the risk of heart disease and stroke is even higher. Like CRP, researchers still don't know if the substance causes cardiovascular disease or is simply an indicator that it exists. Kidney disease and some medications can also increase homocysteine levels. Genetic makeup, sex and diet may play a big role in determining homocysteine levels. Females have lower levels and folate and vitamins B6 and b12 have a significant effect on homocysteine levels. High levels of the substance is frequently followed by a recommendation for a dietary change to include the above but it is not yet proven that reducing the levels will reduce the mortality from cardiovascular disease. Fibrinogen is a crucial protein needed for clotting. Excess fibrinogen causes too much clotting or clumping increasing the risk of heart attack or stroke. It is also believed to be an inflammation marker for atherosclerosis. People with diabetes, high blood pressure, high alcohol consumption, high intake of estrogen from the pill or hormone therapy and obesity or are inactive and smoke also tend to have higher fibrinogen levels. Lipoprotein (a) is produced when LDL cholesterol attaches to a specific protein which may interfere with the body's ability to dissolve blood clots. There is still dispute over some study results that indicate that increased lipoprotein(a) levels are associated with increased risk of cardiovascular disease. Several factors may affect lipoprotein(a) levels: dialysis, kidney transplant, poor kidney functioning and hormonal changes associated with diabetes, pregnancy or menopause. Diet and exercise don't seem to affect lipoprotein(a) levels but it tends to be higher in black people.
Source: summary of medical news story as reported by MayoClinic
About: New risk factors may be associated with cardiovascular disease risk
Date: 14 January 2005
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