Significant race and gender differences exist in CRP levels, with women and black subjects having higher levels, which challenges the use of a uniform threshold for cardiovascular risk assessment.
OBJECTIVES: This study sought to determine whether there are race and gender differences in the distribution of C-reactive protein (CRP) levels. BACKGROUND: Few data are available comparing CRP distributions in different race and gender groups. Recent clinical practice recommendations for CRP testing for cardiovascular risk assessment suggest a uniform threshold to define high relative risk (>3 mg/l). METHODS: We measured CRP in 2,749 white and black subjects ages 30 to 65 participating in the Dallas Heart Study, a multiethnic, population-based, probability sample, and compared levels of CRP between different race and gender groups. RESULTS: Black subjects had higher CRP levels than white subjects (median, 3.0 vs. 2.3 mg/l; p 3 mg/l was 31%, 40%, 51%, and 58% in white men, black men, white women, and black women, respectively (p 3 mg/l remained more common in white women (odds ratio OR 1.6; 95% confidence interval CI 1.1 to 2.5) and black women (OR 1.7; 95% CI 1.2 to 2.6) but not in black men (OR, 1.3; 95% CI, 0.8 to 1.9) when compared with white men. CONCLUSIONS: Significant race and gender differences exist in the population distribution of CRP. Further research is needed to determine whether race and gender differences in CRP levels contribute to differences in cardiovascular outcomes, and whether thresholds for cardiovascular risk assessment should be adjusted for different race and gender groups.
“We found that a greater percentage of women had CRP levels above 3 mg/L, yet women have a lower risk of cardiovascular events. This implies that perhaps the cut-offs that we use in CRP to indicate different risk levels may have to be adjusted for different race and gender groups.”
Khera et al. (Sat,) studied this question.