High-Sensitivity C-Reactive Protein and Cardiovascular Disease Across Countries and Ethnicities

Abstract

Despite substantial differences in ethnicities, habits, cultures, the prevalence of traditional cardiovascular risk factors and affordable therapies, atherosclerosis remains the major cause of death in developing and developed countries.However, irrespective of these differences, inflammation is currently recognized as the common pathway for the major complications of atherosclerosis, stroke, and ischemic heart disease. A PubMed search was conducted for “high-sensitivity C-reactive protein” (hs-CRP) in combination with the terms race, ethnicity, gender, prevalence, geographic, epidemiology, cardiovascular, obesity, diabetes, hypertension, cholesterol, smoking, ischemic heart disease, stroke, and mortality. This review includes the articles that pertained to the topic and additional articles identified from the reference lists of relevant publications.This review describes the marked differences in cardiovascular mortality across countries and ethnicities, which may be attributed to inequalities in the prevalence of the classic risk factors and the stage of cardiovascular epidemiological transition. However, hs-CRP appears to contribute to the prognostic information regarding cardiovascular risk and mortality even after multiple adjustments. Considering the perception of cardiovascular disease as an inflammatory disease, the more widespread use of hs-CRP appears to represent a valid tool to identify people at risk, independent of their ancestry or geographic region. In conclusion, this review reports that the complications associated with vulnerable atherosclerotic plaques are triggered by the major mechanisms of dyslipidemia and inflammation; whereas both mechanisms are influenced by classic risk factors, hs-CRP contributes additional information regarding cardiovascular events and mortality.

High Sensitivity C-Reactive Protein as Atherogenic Marker Among Type 2 Diabetes

“…Indeed, many cardiovascular events occur in individuals with plasma cholesterol concentrations at or below the National Cholesterol Education Program thresholds (Packard & Libby, 2008). Among the several biomarkers that have been proposed for cardiovascular risk stratification, hs-CRP appears to contribute to the identification of people at risk of developing CVD (Fonseca & Izar, 2016). Data from the current study confirms that the high hs-CRP levels associated with diabetes, that is, the third and fourth hs-CRP quartiles characterized by high percent of diabetic patients compared to the lowest hs-CRP quartiles.…”

Evaluation of Procalcitonin and hs-CRP Levels in Sudden Sensorineural Hearing Loss

“…Although procalcitonin is primarily used to help guide physicians to support the presence of bacterial infections, previous research has reported slightly elevated procalcitonin levels during localized bacterial infection and viral infection [15] . In a recent review, hs-CRP was reported to be a valid tool to identify people at a risk of cardiovascular events independent of their demographic background [16] . Xie et al [17] suggested that hs-CRP is associated with internal carotid artery occlusion in ischemic stroke patients.…”

Serum C‐reactive protein in the prediction of cardiovascular diseases: Overview of the latest clinical studies and public health practice

“…In 2003, the AHA/CDC panel recommended a significant need to study ethnic differences in CRP concentrations (Doran, Zhu, & Muennig, 2013;Nazmi & Victora, 2007). Based on population-based studies, most white individuals had the lowest CRP concentrations, but African-Americans, South Asians, and Hispanics showed the highest concentrations (Fonseca & Izar, 2016;Ford et al, 2003;Nazmi & Victora, 2007). The level of CRP in African-Americans was higher than that in white individuals (median, 3.0 vs. 2.3 mg/L; p < 0.001), whereas white women, African American women, and black men, all had higher CRP levels in comparison with white men, and the highest levels were observed among black women.…”