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Better Heart Disease Clues for Seniors
Oct. 20, 2003 -- More silent clues to imminent heart attack and stroke are emerging.
Two blood chemicals called interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) -- which indicate chronic inflammation in the body -- seem to predict more accurately than C-reactive protein (CRP) the early signs of heart disease in older people.
That's the key here: older people. Although there are traditional risks factors for heart disease -- being male, family history, smoking, and cholesterol, many studies have shown that these risks factors become less predictive of heart disease as a person ages.
The body makes all three of these blood proteins, and many studies have linked high levels of them to future heart disease risk.
High levels, especially of CRP, for long periods of time can predict a high risk of heart attack, stroke, and sudden cardiac death.
This newest study showed that IL-6 and TNF-alpha were more significant predictors of life-threatening events.
"The link between CRP and heart disease may be weaker in older people," says lead researcher Matteo Cesari, MD, with the Stricht Center on Aging at Wake Forest University School of Medicine in Winston-Salem, N.C, in a news release.
Cesari and his colleagues studied 2,225 men and women aged 70 to 79, all with no signs of heart disease, for nearly four years. During that time, there were 188 heart attacks, 60 strokes, and 92 cases of congestive heart failure.
- Those with high levels of IL-6 had a two- to fivefold increased risk of heart attack, stroke, or congestive heart failure.
- Those with high levels of TNF-alpha had 79% higher risk of heart attack and more than double the risk of heart failure.
- High CRP levels were associated with more than double the risk of congestive heart failure. CRP was not linked with heart attack or stroke.
Significantly higher risk was found in those who had smoked, had diabetes, high blood pressure, emphysema, high body mass index, high levels of triglycerides, and low levels of "good" HDL cholesterol.
However, even without those traditional risk factors, high levels of all three inflammatory markers -- IL-6, TNF-alpha, and CRP -- proved the best predictors for heart attack and heart failure. They predicted future stroke to a lesser degree.
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