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American Morning

Look at Another Warning Sign for Heart Attacks

Aired November 14, 2002 - 08:43   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


PAULA ZAHN, CNN ANCHOR: Time for our House Call, Paging Dr. Gupta. You may think you're doing all you can to keep heart attacks at bay by having your cholesterol checked, but researchers now saying there is another trigger you may be ignoring, inflammation, and you might need another test to detect it, and it's not that expensive, all things considered.
And Joining us now from Atlanta with details is our own medical correspondent, Dr. Sanjay Gupta.

Good morning, doctor.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Paula.

It's call C-reactive protein, and I imagine a big discussion topic, as big as cholesterol was just a few years ago. What is it, how does it work? And most importantly, what do patients think about it? Let's take a look.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): She never thought it would be that hard. Eat right, exercise, get some fresh air, and, of course, keep your cholesterol low. But Mary Arehart discovered it wasn't that easy.

MARY AREHART, HEART PATIENT: My cholesterol was always good, it was about 168, which is what it was when I had my heart attack. They're always saying under 200, that's great.

GUPTA: That's because of the over 300 risk factors, doctors look to the bad cholesterol number almost as if it was a crystal ball to predict heart disease. The problem is the science keeps changing.

Dr. Paul Ricker noticed that change early on.

DR. PAUL RICKER: We've known for sometime that half of all heart attacks and strokes in the United States occur among individuals who actually have normal, if not low, cholesterol levels.

GUPTA: Now, Dr. Ricker has published the strongest evidence yet about a new test. It's called C-reactive protein, or CRP. It's a blood test, simple and expensive and works by measuring painless inflammation inside the body. While Mary Arehart's cholesterol was normal, her CRP was dangerous.

AREHART: Had I known about this test, I would have asked for it at my yearly exam. I think it would have benefited me quite a bit. I think, by then, we actually would have known that I was already in trouble, and maybe we could have prevented the heart attack.

GUPTA (on camera): Today, dr. Ricker and many other doctors believe C-reactive protein is actually a better predictor of heart disease than cholesterol, but your best is to get both checked.

RICKER: Cholesterol tells us a very important part of the risk equation, and the CRP tells us a different part of the equation. It is using these two things together that really helps us to understand a patient's true risk.

GUPTA (voice-over): Of course, with every new test, there are cautions.

DR. ROBERT BONOW, AMERICAN HEART ASSN.: Exactly who should be measured and when to measure it is something that still requires a very careful evaluation.

GUPTA: That's because doctors know that a high number is bad, but still aren't exactly sure what number is safe. The American Heart Association, along with the CDC, hope to release guidelines soon.

(END VIDEOTAPE)

GUPTA Meanwhile, Mary is urging her siblings to have their CRP levels checked so they know if they are at risk and can benefit from a warning she didn't have. It is estimated that about 25 percent of people who have low cholesterol levels have very high CRP levels. So there may be a new warning sign, a new signal to actually look for heart disease early.

ZAHN: So is this something people should be asking their doctors for when they go for their annual exams, assuming they go for their annual exams, of course?

GUPTA: Right, that's the first step, no question. I think it's something that every patient probably will get soon. As they mentioned there, we are not quite ready to release guidelines, the doctors aren't quite ready to release guidelines, as to what all the numbers mean.

For example, if your CRP is very high, we know that puts you at risk, but what number's actually going to be safe, what number should you just be placed on medications for, and what number should you not worry about at all. Those numbers still need to be flushed out a bit, but I think, pretty soon, it's going to become a very, very common test -- Paula.

ZAHN: Explain to us, doctor, once again. We are a little dense when it comes to medical matters here. You are the expert. How many people out there would have a normal cholesterol reading, but have the high CRP reading.

GUPTA: They say they predict -- obviously, they haven't screened the whole country yet, but they estimate, based on what they have done so far, about 25 percent of people. People go out there, and they get their cholesterol, and they say, hey, you know what, my cholesterol looks good, it's fine, it's normal, don't need to worry about things. Twenty-five percent of people that have that will also have very high CRP levels, which could be a warning sign. So another test there.

ZAHN: and we heard what the woman did to lower her cholesterol ratings. And once again, if you wanted to lower your CRP ratings, the same thing?

GUPTA: It's really the same things, yes, I mean, the same old rules that we've talked about on your show, Paula, apply, eat right, exercise, don't smoke. All those sorts of things will also bring down your CRP level. The real key here, though, is there are people who are at risk that may not know it that need to pay more attention to those things, and this test is going to will help find those people a little bit more easily.

ZAHN: Personal question, have you taken the test?

GUPTA: I have not yet.

ZAHN: You're too young. You're a young lad, like Bill Hemmer.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com






Aired November 14, 2002 - 08:43   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, CNN ANCHOR: Time for our House Call, Paging Dr. Gupta. You may think you're doing all you can to keep heart attacks at bay by having your cholesterol checked, but researchers now saying there is another trigger you may be ignoring, inflammation, and you might need another test to detect it, and it's not that expensive, all things considered.
And Joining us now from Atlanta with details is our own medical correspondent, Dr. Sanjay Gupta.

Good morning, doctor.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Paula.

It's call C-reactive protein, and I imagine a big discussion topic, as big as cholesterol was just a few years ago. What is it, how does it work? And most importantly, what do patients think about it? Let's take a look.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): She never thought it would be that hard. Eat right, exercise, get some fresh air, and, of course, keep your cholesterol low. But Mary Arehart discovered it wasn't that easy.

MARY AREHART, HEART PATIENT: My cholesterol was always good, it was about 168, which is what it was when I had my heart attack. They're always saying under 200, that's great.

GUPTA: That's because of the over 300 risk factors, doctors look to the bad cholesterol number almost as if it was a crystal ball to predict heart disease. The problem is the science keeps changing.

Dr. Paul Ricker noticed that change early on.

DR. PAUL RICKER: We've known for sometime that half of all heart attacks and strokes in the United States occur among individuals who actually have normal, if not low, cholesterol levels.

GUPTA: Now, Dr. Ricker has published the strongest evidence yet about a new test. It's called C-reactive protein, or CRP. It's a blood test, simple and expensive and works by measuring painless inflammation inside the body. While Mary Arehart's cholesterol was normal, her CRP was dangerous.

AREHART: Had I known about this test, I would have asked for it at my yearly exam. I think it would have benefited me quite a bit. I think, by then, we actually would have known that I was already in trouble, and maybe we could have prevented the heart attack.

GUPTA (on camera): Today, dr. Ricker and many other doctors believe C-reactive protein is actually a better predictor of heart disease than cholesterol, but your best is to get both checked.

RICKER: Cholesterol tells us a very important part of the risk equation, and the CRP tells us a different part of the equation. It is using these two things together that really helps us to understand a patient's true risk.

GUPTA (voice-over): Of course, with every new test, there are cautions.

DR. ROBERT BONOW, AMERICAN HEART ASSN.: Exactly who should be measured and when to measure it is something that still requires a very careful evaluation.

GUPTA: That's because doctors know that a high number is bad, but still aren't exactly sure what number is safe. The American Heart Association, along with the CDC, hope to release guidelines soon.

(END VIDEOTAPE)

GUPTA Meanwhile, Mary is urging her siblings to have their CRP levels checked so they know if they are at risk and can benefit from a warning she didn't have. It is estimated that about 25 percent of people who have low cholesterol levels have very high CRP levels. So there may be a new warning sign, a new signal to actually look for heart disease early.

ZAHN: So is this something people should be asking their doctors for when they go for their annual exams, assuming they go for their annual exams, of course?

GUPTA: Right, that's the first step, no question. I think it's something that every patient probably will get soon. As they mentioned there, we are not quite ready to release guidelines, the doctors aren't quite ready to release guidelines, as to what all the numbers mean.

For example, if your CRP is very high, we know that puts you at risk, but what number's actually going to be safe, what number should you just be placed on medications for, and what number should you not worry about at all. Those numbers still need to be flushed out a bit, but I think, pretty soon, it's going to become a very, very common test -- Paula.

ZAHN: Explain to us, doctor, once again. We are a little dense when it comes to medical matters here. You are the expert. How many people out there would have a normal cholesterol reading, but have the high CRP reading.

GUPTA: They say they predict -- obviously, they haven't screened the whole country yet, but they estimate, based on what they have done so far, about 25 percent of people. People go out there, and they get their cholesterol, and they say, hey, you know what, my cholesterol looks good, it's fine, it's normal, don't need to worry about things. Twenty-five percent of people that have that will also have very high CRP levels, which could be a warning sign. So another test there.

ZAHN: and we heard what the woman did to lower her cholesterol ratings. And once again, if you wanted to lower your CRP ratings, the same thing?

GUPTA: It's really the same things, yes, I mean, the same old rules that we've talked about on your show, Paula, apply, eat right, exercise, don't smoke. All those sorts of things will also bring down your CRP level. The real key here, though, is there are people who are at risk that may not know it that need to pay more attention to those things, and this test is going to will help find those people a little bit more easily.

ZAHN: Personal question, have you taken the test?

GUPTA: I have not yet.

ZAHN: You're too young. You're a young lad, like Bill Hemmer.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com