Inflammatory Biomarker CRP Linked To Heart Disease Risk in African American Women Interview with:
Norman C. Wang, M.D., M.S., Assistant professor
University of Pittsburgh School of Medicine
Samar R. El Khoudary, Ph.D., M.P.H.,
Assistant professor of Epidemiology
University of Pittsburgh Graduate School of Public Health What is the background for this study? What are the main findings?

Response: We examined medical records, blood samples and heart CT scans for 372 black and white women from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women averaged just over 51 years old, were not on hormone replacement therapy and had no known heart disease when enrolled. We then looked at blood levels of five biomarkers linked to inflammation. All of the biomarkers were associated with coronary artery calcification, a predictor of heart disease that is measured with a heart CT scan.

Taking into account the participants’ body mass index (BMI), a measure of overall body fat, we found that obesity was a key factor linking most of the elevated inflammation biomarkers and coronary artery calcification. Regardless of BMI, black women with higher levels of one particular biomarker, C-reactive protein, were more likely to have coronary artery calcification than whites. In fact, black women with coronary artery calcification had an average level of C-reactive protein in their blood that was almost double that of their white counterparts. What should readers take away from your report?

Response: Multiple previous studies have shown that black women are at higher risk for heart disease than white women; however, guidelines for assessing cardiovascular disease risk in asymptomatic adults do not recommend selective race- or ethnic-based risk-assessment. Our study revealed for the first time that in black, but not white, women going through menopause, higher levels of C-reactive protein, an easily measured risk factor for heart disease, are associated with higher amounts of early atherosclerosis, even after accounting for other risk factors for heart disease. Obesity, inflammation biomarkers and coronary artery calcification are linked for both black and white midlife women, further emphasizing the need to promote lifestyle changes to combat obesity at midlife when women are subjected to many physiological and biological changes that could potentially increase their risk for heart disease What recommendations do you have for future research as a result of this study?

Response: Future research should build on our findings regarding black women and C-reactive protein by testing similar associations over time, which could potentially yield interventions that can help these women avoid developing heart disease. Is there anything else you would like to add?

Response: Our study only looked at black and white women, so the results are not generalizable to other racial or ethnic groups. Additional researchers on the study are Karen A. Matthews, Ph.D., Emma J.M. Barinas-Mitchell, Ph.D., and Chung-Chou H. Chang, Ph.D., all of Pitt. The research was funded by the National Institutes of Health (NIH). Thank you for your contribution to the community.


Inflammatory/hemostatic biomarkers and coronary artery calcification in midlife women of African-American and White race/ethnicity: the Study of Women’s Health Across the Nation (SWAN) heart study Wang, Norman C. MD, MS; Matthews, Karen A. PhD; Barinas-Mitchell, Emma J.M. PhD; Chang, Chung-Chou H. PhD; El Khoudary, Samar R. PhD, MPH

June 2016 – Volume 23 – Issue 6 – p 653–661
doi: 10.1097/GME.0000000000000605

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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