Does CRP hold key to the heart disease problem?

C-reactive protein, commonly known as CRP is a marker for inflammation. This can be measured by a simple blood test. Several recent research studies have shown that persons with high CRP have a higher chance of developing blockages of heart arteries. Following are some important points to understand about CRP

- We do not know if high CRP is cause or just a marker of heart disease

- We still do not have a medicine that will act purely as CRP lowering agent. We also have not proven that lowering CRP alone will translate into lowering heart disease.

- The studies have shown that CRP is high in patients with conventional heart disease risk factors. Some studies have also shown that usual measures for heart health like exercise lower CRP.

Based on all this, you can’t help questioning the utility of knowing CRP in addition to knowing classical risk factors.

I can see utility of CRP in some scenarios:

- If you are a person without or with heart disease, and seeing some numbers may help motivate you to take better care of yourself.

- If you have borderline cholesterol, a high CRP may make a stronger case for cholesterol lowering medications.

(c)Keshav Chander

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Ashamed That You Had a Heart Attack?

Once I treated a very healthy looking heart attack patient. At the time of discharge from the hospital, he confided in me that he was nervous about going back home. He told me that he was seen as an epitome of good health in his little town. He felt that he had somehow let his people down by having a heart attack.
Whenever a new heart patient comes to the hospital, it is routine to ask if the patient smokes, exercises, eats right, takes good care of his or her diabetes or blood pressure. It seems that these questions may somehow make the patients feel guilty; guilty of bringing the problem on themselves.
Against this background, I wonder if there is a stigma attached to heart disease. And if this stigma prevents some people from seeking medical attention leading (at times) to fatal consequences.
If you have had heart disease, here are my two questions:
- Did you feel like people made you feel like you single-handedly brought it to yourself?
- Do you think a perceived stigma attached to heart disease may have delayed your seeking medical attention?

(c) Keshav Chander

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Cholesterol Lowering Medicines' (Statin) Prices Got You Beat? Some money saving tips.

High price of statin drugs is one of the commonest frustrations of my patients with heart problems. The statins are a commonly used group of medicines used to lower cholesterol. Zocor, Lipitor, Crestor, Pravachol and Lovastatin are some of the statins available. Here are some tips on saving money on statins:
1. For the first time, three statins, Lovastatin, Pravastatin (marketed under name Pravachol) and Simvastatin ( marketed as Zocor) are available in generic form now. Request your health provider to prescribe generic statins.
2. All generics are not priced the same. Shop around, and buy the least expensive one. The more expensive medicine is not necessarily the better medicine.
3. Just because a particular pharmacy gave you the best price for one medicine does not mean all the medicines in that pharmacy are best-priced. Shop around for each individual drug that you may have to take on a regular basis.
4. Do not hesitate to ask your health provider for drug samples. Also, ask for any drug assistance programs that they may know of. Your doctor's medical assistant or nurse can be your best resource in this regard.
5. Don't get swayed by an article or advertisement into hopping from one statin to another.
6. If you are charged considerably more for one statin than the other, consider changing to a cheaper one. Most of the health providers will be happy to oblige by changing your prescription unless they see a good reason for sticking with the more expensive one.

(c) Keshav Chander

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