Know your heart-healthy numbers – including CRP

“Know your numbers.” It’s a common theme surrounding heart health. Most doctors agree you should know your blood pressure, blood sugar and cholesterol so you can make changes to improve your health and reduce your risk of heart problems.

But there’s one more number people should be aware of: C-reactive protein (CRP).

CRP is a marker for inflammation in the body. It’s been shown that, when used in conjunction with cholesterol levels, it can help us better understand a person’s risk for heart disease. In fact, one analysis showed that the risk of a future heart event was more than 50 percent higher when CRP levels were over 3 mg/L.

Unfortunately, people often emphasize their cholesterol levels without considering any other factors. They think if their cholesterol is low, they are at low risk for heart disease. That may not always be the case. Knowing both your CRP and cholesterol levels is more powerful than knowing one alone.

Let’s take a closer look at how your CRP affects your heart risk. That way, the next time your doctor prepares to test your cholesterol, you can also ask about your CRP level.

What is CRP, and what does it tell us about heart health?

CRP is a ring-shaped protein produced in the liver in response to inflammation in the body. Inflammation is part of the body’s response to fighting infection. We all have a low level of inflammation at any given time. That’s normal and healthy.

While the exact role inflammation plays in heart disease is a topic of ongoing research, we do know that having a high level of inflammation over a long period of time creates heart risk. And we know we can measure inflammation in the body by testing CRP levels.

Checking your CRP involves a simple blood test. If you’re getting your cholesterol tested, we can use the same tube of blood. No extra needle sticks are necessary.

Your CRP level puts you in one of three categories:

  • Low risk: Less than 1 mg/L
  • Average risk: 1 to 3 mg/L
  • High risk: Greater than 3 mg/L

However, your CRP can’t tell us everything. It’s important to look at it in relation to your cholesterol, specifically low-density lipoprotein (LDL). LDL is considered the bad cholesterol because it collects in your arteries and can cause blockages. Your CRP modifies your LDL level.

Here’s how it works: If you have a low LDL but a high CRP, the high CRP reduces the benefit of a low LDL. You’re at increased risk. And it’s the same in reverse: If you have a high LDL but a very low CRP, that low CRP reduces the risk from the high LDL.

In fact, the American Heart Association and the Centers for Disease Control and Prevention say it’s reasonable to measure CRP as a part of heart disease risk assessment. It’s not considered mandatory, but patients and their doctors should discuss its potential benefits.

Once you know your numbers, there is a very simple online scoring tool you can use to predict your heart risk over the next 10 years.

How can you lower your CRP?

What causes a high CRP? It’s a combination of genetics, health and lifestyle factors, including:

  • Chronic inflammatory conditions such as rheumatoid arthritis, lupus, psoriasis and gum disease
  • Excess body fat
  • Low physical activity
  • Smoking

The good news is that there are many ways to lower your CRP. Most are the same things you should be doing to live a heart-healthy lifestyle: eat a healthy diet, exercise and quit smoking. If you have a chronic inflammatory condition, work with your doctor to manage it effectively.

Studies, including one I authored, have shown statins also can reduce CRP. Statins are a class of drugs typically prescribed to lower cholesterol levels and reduce the risk of heart attack and stroke. Current guidelines advise the use of statins for people with:

  • Known heart disease
  • Elevated levels of LDL cholesterol
  • Diabetes
  • An estimated 10-year risk of a heart event greater than 7.5 percent

And the JUPITER study showed statins could benefit otherwise healthy people with high CRP levels by cutting their risk of heart disease and death from heart disease by almost half. This would indicate we should take CRP into effect when assessing a person’s heart risk.

Who should get their CRP tested?

I recommend anyone who has their cholesterol checked to also have their CRP tested. As I said earlier, we can use the same blood draw; we simply check one more box for the lab to test.

Just like with cholesterol, the earlier we identify a high CRP levels, the more time we have to prevent potential heart problems through lifestyle changes and, if necessary, medical treatments.

CRP is simply one more way to optimize our understanding of someone’s heart risk. And high CRP is treatable! So the next time you’re in the doctor’s office, ask about your numbers. All of them.

Request an appointment to test your heart-health numbers.

The surprising heart risks of too much sleep and exercise

You’ve probably heard a lot about how getting exercise and sleep can help you avoid heart troubles in the future. But getting too much of either can actually increase your risk of heart disease.

It seems counterintuitive. After all, we’re constantly told that exercising regularly and getting enough sleep are vital to staving off obesity, high blood pressure, stroke and, of course, heart disease. And it’s true. Exercise and sleep are important components of a healthy lifestyle. So, wouldn’t exercising even more and getting lots of sleep make us healthier and less prone to heart disease?

Surprisingly, the answer is no. Excessive sleep and over-exercising can increase your risk for heart disease, just like not getting enough sleep or exercise can. In many disciplines, from economics to communication, this phenomenon is known as the “Goldilocks effect,” referring to the children’s story of “Goldilocks and the Three Bears.”

Here’s how can you balance your sleep and exercise to find the amount that isn’t too much or too little, but instead “just right” for your heart health.     

How sleep affects the heart

There is still some debate about the exact amount of sleep that’s ideal for adults. However, researchers have reached a consensus on the optimum range. Almost everyone needs between seven and nine hours of sleep every day. And no, you can’t “catch up” on the weekends. It’s much better for your body’s circadian rhythm–the natural sleeping and waking cycle–to go to bed and wake up at a relatively consistent time each day.

Some people are naturally long sleepers, about two percent of the population. These people need 10 to 12 hours of sleep, or they feel tired and groggy throughout the day. However, most people should not be sleeping more than nine hours per day.  

Oversleeping has been linked to increased inflammation–in which the body’s immune system attacks healthy tissue. Chronic inflammation, or inflammation that occurs over months or even years, can put you at greater risk for cancer, diabetes, heart disease and many other health problems.

Getting too little sleep or too much sleep can increase inflammation levels. But considering that fewer people are aware of the dangers of oversleeping compared to undersleeping, it’s important to emphasize that both can lead to heart problems in the future. A study of the National Health and Nutrition Examination Survey found that, compared to people who get six to eight hours of sleep, those who slept:

  • Less than six hours: Had a doubled risk of stroke or heart attack
  • More than eight hours: Had a doubled risk of angina – chest pain due to reduced blood flow – and 10 percent higher risk of coronary artery disease

If you’re having trouble getting between seven and nine hours of sleep each night, bring it up to your doctor at your next physical. While short-term sleep problems aren’t likely to cause lasting damage, developing poor sleep habits can put you at higher risk for heart trouble as well as other problems later in life.

How exercise affects the heart

On the whole, Americans don’t exercise nearly enough. About half of U.S. adults don’t get enough aerobic physical activity – the heart-strengthening exercises known as “cardio.” Aerobic exercise is one of the best ways to safeguard against future heart disease and improve your overall health. However, too much vigorous aerobic exercise can also be detrimental to your heart health.

Like a few days of getting too little sleep, brief bouts of high-intensity cardio followed by periods of rest won’t do lasting damage. In fact, it can make your heart stronger. Problems arise when extreme athletes – such as long-distance runners, rowers, swimmers and cyclists – perform vigorous exercise regularly.

Intense aerobic physical activity puts a strain on your heart. Over time, repeated strain changes the very structure of the heart, enlarging the arteries and right ventricle and causing thick scar tissue to form in the heart’s two atria. These adaptations have been linked to heart problems in some people, though more research is needed for us to draw definitive conclusions.

There are many misconceptions about how intense exercise needs to be to achieve the best results. I find that many people believe they have to be totally out of breath and drenched in sweat to get a “good workout,” but the reality is that, as far as your heart is concerned, you’ll maximize your exercise benefits with regular moderate exercise, like a brisk walk. What defines “moderate” exercise? You should sweat a little and be able to carry on a conversation with someone without too much difficulty.

The American Heart Association recommends 150 minutes of moderate physical activity per week, or 75 minutes of vigorous exercise, or some combination of both. I suggest doing 30 to 60 minutes of moderate exercise on most days of the week. That’s a healthy habit that you can continue through your whole life. 

This doesn’t mean you shouldn’t give that marathon or triathlon you’ve always wanted to do a try. I’ve finished 11 marathons and a 50-mile race, so I know the allure of such events. The positives of endurance training are many: fitness, strength, even psychological. But we need to remember that more isn’t always better. Talk to your doctor before beginning to train for such endurance events. As for me, I still enjoy running and believe strongly in the benefits of exercise, although I’ve moderated my distance over the years, opting for a morning jog on the C&O canal as my favorite run!

Most people don’t have to worry about exercising too much or oversleeping. In fact, they should be concerned about too little exercise and sleep! But for extreme athletes and chronic sleepers, these issues can lead to heart problems in the future. The trick to the Goldilocks effect of sleep and exercise is finding a balance that makes you feel “just right.”


Request an appointment online or call 202-877-3627 to talk to a doctor about how your sleep and exercise routine affects your heart.


Walk with a Doc: Take Steps to a Healthier You

Walk your way to better health and get answers to your most pressing health questions from an experienced physician by joining MedStar Washington Hospital Center’s Walk with a Doc walking team. Come out on the first Saturday of every month—rain or shine at the National Arboretum Visitors Center at 9 a.m. to be a part of this important and worthwhile journey. 

One of a Kind in the DC Region

The Hospital Center wants you to be as healthy as you can be. Walk with a Doc combines exercise with the chance to talk with a qualified and accomplished physician as you stroll your way to a healthier you. It’s free, easy and the only one of its kind in the Washington DC area.

Benefits of Walking

Statistics show a link between physical activity and reduced risk of heart disease. Walking can improve your total cholesterol, blood sugar and resting heart rate. Just 30 minutes a day, seven days a week will give you this tremendous benefit that can reduce your risk of heart disease, stroke and cancer by as much as 50 percent. You can even break it up into quick and manageable 10-minute sessions, three times a day.

Lessons Learned While Walking

During a previous Walk with a Doc event, Dr. Patricia Davidson, a prominent cardiologist and internist, informed the group that heart disease is the number 1 killer of men and women and the most preventable. She stressed the importance of “knowing your numbers” for LDL, HDL and triglycerides:

  1. LDL (Low-density lipoprotein) is also known as the bad cholesterol. You should strive for LDL cholesterol of less than 100. Genetics can be a factor in a high LDL. Or, you may be eating too much animal fat.
  2. HDL (High-density lipoprotein) is known as the good cholesterol. Ideally, your HDL number should be 50 or above. If it is low, you can boost your level by exercising, losing weight and if you smoke, stop. The higher your numbers, the more protective it is to your heart.
  3. Triglycerides are fats carried in the blood from the food we eat. A number lower than 150 is ideal. If your numbers are high, cut back on carbohydrates (carbs), excess calories, alcohol, and sugar.

Bottom line, high HDL levels are at lower risk for heart disease. People with low HDL levels are at a higher risk.

It’s Heart Smart to Walk

Your heart is a muscle and it needs exercise to stay in shape. When it's exercised, the heart can pump more blood through the body and continue working at optimal efficiency with little strain. This will likely help it to stay healthy longer. When you exercise on a regular basis, it helps to keep your arteries and other blood vessels flexible, which ensures good blood flow and normal blood pressure and cholesterol.

You’ve likely heard the saying, “a little goes a long way.” That statement applies to exercising. As long as you have a program that you stick to on a regular basis, it works.

So, come out and join us for the next Walk with a Doc event on the 1st Saturday of every month at the National Arboretum, as we walk, talk and exercise our heart.


Have any questions?

We are here to help! If you have any questions about Walk With a Doc, visit our Community Relations website, send an email to [email protected], or call Community Relations at 202-877-9600.

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A Belated Valentine to the Nation’s Capital: Our New Heart & Vascular Hospital Opens

More than 300 donors, former patients, healthcare staff, elected officials, and guests gathered at MedStar Washington Hospital Center on June 16 to witness the dedication of the Nancy and Harold Zirkin Heart & Vascular Hospital, the first dedicated cardiovascular hospital located in the greater Washington, D.C. area. The occasion marked the end of years of planning, design and construction, as well as the beginning of a new era of tightly coordinated, centralized specialty care for the most complex cardiovascular cases in the region.

“This is an extraordinary milestone for our patients,” said Stuart F. Seides, MD, physician executive director of MedStar Heart & Vascular Institute. “Every aspect of the new hospital was designed with patients’ comfort, convenience and safety in mind as we worked to create an environment conducive to healing.”

About the Nancy and Harold Zirkin Heart & Vascular Hospital

The new four-story, 160,000 square-foot, state-of-the-art facility unites virtually the entire heart and vascular healthcare delivery staff—cardiologists, cardiac and vascular surgeons, nurse practitioners, cardiac care nurses, and other specialized caregivers—into one cohesive team in one location, for more effective, streamlined care.

“Previously, patients with heart problems could have received care on one of 10 different nursing units,” says Allen J. Taylor, MD, FACC, FAHA, chief of Cardiology at both MedStar Washington Hospital Center and MedStar Georgetown University Hospital. “This new configuration eliminates variability in care, while fostering communication and collaboration among team members.”

Adds Nancy Bruce, RN, BSN, MBA, assistant vice president for Nursing, “It also makes it possible for us to ensure that the patient/family experience is seamless, and care is coordinated every step of the way.”

From admission to discharge, all aspects of the new hospital-within-a-hospital help promote that goal. Patients are now housed according to condition, treatment and acuity of care, leading to increased proficiency and teamwork for staff members accustomed to caring for patients with diverse heart and vascular diagnoses. Patient floors feature their own echocardiography, X-ray and other non-invasive services for faster, more convenient examinations and evaluations. Stress testing is done on the first floor of the new space. The majority of the 164 patient rooms are also private, furnished with couches and other amenities, to increase the comfort and satisfaction levels of patients and their families.

An Expanded Cardiac Critical Care Unit

July found the opening of the last phase of the project, an expanded 44-bed cardiac critical care unit (CVICU) that combines the functions of the previous three units into one: recovery room, coronary care unit and cardiovascular surgery ICU. A unique feature is a central boom suspended from the ceiling, for medical gasses, electrical and data outlets. By doing away with the old wall mounts, the design gives staff unfettered 360-degree patient access.

“The new, cutting-edge ICU will allow surgeons, intensive care physicians, nurses, and mid-level practitioners to constantly improve care, comfort and efficiency for the sickest patients in the region,” says Paul Corso, MD, chairman, Cardiac Surgery. “The unit is structured for ever-expanding, high-tech monitoring and communication among caregivers, patients and families. Cardiovascular surgery will continue to innovate and add new procedures because of the capabilities of the new ICU. The new Zirkin Heart & Vascular Hospital is the culmination of a dream for cardiovascular care in the mid-Atlantic region.”

Turning a Dream Into Reality

MedStar Washington Hospital Center is one of the busiest cardiac surgical centers in the United States and is nationally recognized for excellence in cardiovascular care. MedStar Heart & Vascular Institute, founded at MedStar Washington Hospital Center, is engaged in a clinical and research alliance with the world-renowned Cleveland Clinic Sydell and Arnold Miller Family Heart & Vascular Institute to improve patient outcomes and operational excellence.   

With the opening of the dedicated heart and vascular hospital, the patient and family experience now matches the hospital’s reputation for outstanding clinical expertise. Thanks go to Nancy and Harold Zirkin and their $10 million leadership gift. “When Nancy and I learned about the vision of MedStar Heart & Vascular Institute and its important alliance with Cleveland Clinic,” Mr. Zirkin says, “we saw this as an ideal opportunity to bring together our strong interest in better health with the region’s need for world-class heart care. We’re thrilled we were able to help make MVHI’s dream a reality.”

Dr. Seides concludes, “We’ve always been blessed with some of the most talented and dedicated physicians and nurses in the country. Now we are providing them with an environment that allows that teamwork to flourish--and ultimately allows us to provide the best possible patient care.”

Have questions?

We are here to help! If you have any questions about MedStar Washington Hospital Center, call us at 202-877-3627.

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29 Things You Should Do for a Healthy Heart

You’re heard it many times before -- follow a healthy lifestyle for a healthy heart. Sounds simple, right?  But it’s not always so easy to pull off. A heart healthy lifestyle can reduce the risk for heart disease by as much as 80%!  But what is a “heart healthy lifestyle”?  It’s a commitment to many habits in our daily lives centered on our activity, diets, mindset and awareness.  There is no one “magic” thing. When lifestyle isn’t enough, talk with your doctor to set goals you can realistically achieve, such as losing weight or lowering your cholesterol or blood pressure levels. Sometimes, it takes medications that can be very helpful to optimizing your heart risk.

So, commit to making the many small lifestyle changes that make a healthy heart a snap! The key to success is to make small changes in many areas. No matter what you do, remember to take it day by day, and work to sustain your gains.

With that in mind, we’ve compiled 29 heart health tips. Knowledge is power!  Read on to find out what you can do to keep your heart healthy. Only you can love your heart. So start today!

1. Make time for exercise: Exercising 30 to 60 minutes on most days will cut your heart risk in half.

2. Know your heart disease risk: Calculate your risk by plugging your numbers into an online calculator.

3. Never ignore your chest pain:  Pain can be felt anywhere in the chest area, arms, your back and neck.

4. Check your blood pressure: Let the healthy blood pressure number be below 140/90. Both numbers matter!

5. No smoking: Don’t smoke, and ask your loved ones to quit.

6. Aspirin: Should you take aspirin? If you have heart disease, yes! If you don’t have heart disease, then maybe not! Ask your doctor.

7. Moderate exercise: How do you know whether you are exercising moderately? You should able to carry on a light conversation

8. Stress: Is it bad for your heart? Yes, sustained stress is, no matter the source. Learn to control your stress to prevent heart disease.

9. Second hand smoke is dangerous! Public smoking bans in the community have reduced heart attack risk by 20%.

10. Sex: Is your heart healthy enough for sex? Sex has a “heart workload” like climbing two flights of stairs.

11. Dark chocolate: Give your loved ones chocolate as a gift on Valentine’s day! Regular chocolate eaters have less heart and stroke risk!

12. Order wine with your dinner! Moderate intake is associated with lower heart risk. (Consume wisely!)

13. Red or white wine? Is one better for your heart? Wine, beer or spirits all show a similar relationship to lower heart risk.

14. The “Mediterranean diet” is the most heart healthy way to eat. Studies show this diet reduces heart attack risk up to 30%.

15. Mediterranean diet = veggies, fruits, nuts, seeds, grains, herbs, spices, fish, seafood, olive oil, poultry, eggs, cheese, yogurt and wine.

16. Take your heart meds fully and faithfully! It’s the only way to get the full benefit of the treatments!

17. Stairs burn twice as many calories as walking. Regular stair climbing reduces your risk of premature death by 15%!

18. The quantified self. Keep moving! Steps per day: Very active >10,000, active >7500, sedentary <5000.

19. Fish eaters have less heart disease! Think about fish as a first choice when eating out- let somebody else do the cooking!

20. Did you know that people who are optimistic have less heart disease? See the bright side- it is truly good for your heart!

21. If you snore, tell your doctor. Snoring can be treated, and could signal risks for your blood pressure and heart rhythm.

22. Want to really know your risk of heart attack? Get a calcium scan of your heart. Accurate, safe, and costs less than dinner for 2!

23. Do you know CPR? Simple! Learn it here and double somebody’s chance of surviving cardiac arrest.

24. Ditch the soda and energy drinks. Please.

25. Coffee lover? For your heart’s sake, it is OK! (But, skip the donut!)

26. Like music? So does your heart! Music listening lowers your heart rate, and blood pressure!

27. Are statin cholesterol drugs safe? For most patients, yes! Unfortunately, over the counter supplements aren’t very helpful.

28. Heart attack or stroke symptoms? Don’t delay! Call 911 immediately. Minutes matter to save lives!

29. Taking vitamins or other supplements for heart disease risk? Be careful- few have little, if any, proven benefit.

Have any questions?

We are here to help! Contact us for more information about heart health or to schedule an appointment. Call us at 202-877-3627.

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