Abstract 1344: Does Knowledge of Elevated High Sensitivity C-reactive Protein (hsCRP) Motivate Patients to Make Positive Lifestyle Changes to Reduce Cardiovascular Disease (CVD) Risk?
The AHA and CDC suggest a benefit of measuring hsCRP beyond traditional risk factors is to motivate patients to make lifestyle changes to reduce CVD risk, however this hypothesis has not been formally tested. The purpose of this study was to determine if individuals randomized to a screening and educational intervention who were informed they had above normal hsCRP (≥1mg/L) were more likely to adhere to prevention goals at 1 year compared to those informed their levels were normal independent of confounders.
Methods: Adult family members of patients hospitalized with CVD randomized to the educational intervention arm in the NHLBI sponsored Family Intervention Trial for Heart Health (FIT Heart) received personalized information on CVD risk factors including hsCRP and counseling how to lower hsCRP through lifestyle if elevated (n=250; 66% female; 36% non-white). Standardized risk factors were collected on all subjects at baseline and 1 year. Diet was assessed by validated questionnaires. Lipids were measured in the Columbia University CTSA core laboratory and for educational feedback purposes hsCRP was analyzed by validated fingerstick technology. Regression models were constructed to adjust for confounders to evaluate hsCRP as an independent predictor of lifestyle change at 1 year.
Results: Participants with elevated hsCRP vs. those with normal levels were significantly more likely to have a family history of CVD (p=.04), be overweight/obese/increased waist size (p<.0001) have increased diastolic blood pressure (p=.04), lower HDL-C (p<.0001) and higher triglycerides (p<.0001). Baseline hsCRP was a significant inverse predictor of physical activity levels at 1 year (p=.03) but not dietary score. Individuals with elevated hsCRP had significantly less increase in mean % change in waist circumference at 1 year vs those with normal levels (1.5% vs 3.4%, p=.03). When adjusted for confounding, hsCRP did not predict lifestyle changes at 1 year.
Conclusion: These data suggest baseline hsCRP may predict lifestyle in the context of an educational intervention but it may not be an independent effect.