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APHA Scientific Session and Event Listing

Recorded presentation

Sally Fontamillas Shaw, DrPH¹, Bruce Nelson, MA¹, Joseph Bornheimer, MD², and Lee Allen, RN². (1) Community Services, Glendale Adventist Medical Center, 1509 Wilson Terrace, Glendale, CA 91206, 818-409-8547, shawsf@ah.org, (2) Heart and Vascular Institute, Glendale Adventist Medical Center, 1509 Wilson Terrace, Glendale, CA 91206

Chronic inflammation has recently been recognized as the primary contributor in the formation of arterial plaques leading to cardiovascular disease. A key immune inflammatory mediator associated with chronic inflammation is high sensitivity C-reactive protein (hs-CRP). Approximately 25 percent of the U.S. population has elevated hs-CRP levels with normal or low LDL cholesterol levels. Researchers have shown that hs-CRP is a stronger predictor of cardiovascular events than LDL. Based on these findings, we have implemented an innovative outreach strategy, utilizing a self-scored risk-assessment survey to prescreen thousands of community residents. The validity of this survey is based on correlative clinical studies relating hs-CRP levels in response to specific survey questions. Participants scoring above an identified threshold are considered to have a moderate or higher risk for heart disease and are tested for elevated hs-CRP and cholesterol. Of the 4,082 prescreened so far, 32% were identified as at-risk for cardiovascular disease. Of the 577 clinically tested, 37% showed elevated hs-CRP levels with normal cholesterol levels, which is greater than predicted in the literature. In addition, 87% reported key cardiovascular-related symptoms. Those with elevated hs-CRP/cholesterol levels and/or symptomatic receive case-managed referrals to medical care and health education classes. Our model demonstrates that clinical hs-CRP testing integrated in a population health screening model can be a more effective predictor for cardiovascular disease than LDL cholesterol.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Recognize the value of hs-CRP testing in conjunction with cholesterol testing among high-risk populations.
• List 3-4 risk assessment strategies to reduce cardiovascular disease risk
• Describe the significance of using a prescreening survey to determine cardiovascular disease risk.

Keywords: Heart Disease, Community Health Assessment

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation