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Episode 54 finishes off the whole issue of CRP measurement by looking at the evidence we have about what happens to patients when they take drugs that lower CRP – glitazones, COX-2s, fibrates, vitamin E, niacin, ezetimibe, and statins. Other than statins and maybe niacin, it doesn’t look good – in contrast to Mike and James of course that is.
Show Notes
1) Drugs that lower CRP
Cardiovasc Drug Rev 2006;24:33-50
Atherosclerosis 2005;179:361-7
2)Drugs that lower CRP and their effect on outcome
Glitazones
COX-2s
Fenofibrate
Bezafibrate
Vitamin E
Niacin
Ezetimibe
Statins
High dose statins – not treating to target
{ 2 comments… read them below or add one }
As good as it gets !!! Would you elaborate on intensive vs moderate BP tx in the setting of stage 2-3 CKD or DM ? Personally i reviewed ABCD, AASK, MDRD trials and a little bit of HOT recently and I couldn’t see any clear advantage but I kept being told to tx BP “aggresively”. Also it would be also great if you detail the proteinuria. I am not clear on proteinuria in the course of higher CV risk or ESRD. It seems to be a surrogate marker but treating this marker does not seem to improve the outcome according to ONTARGET trial. Lastly, this podcast is one of the best regarding CRP.
Hi Nevermind – thanks for the compliment and thanks for listening to the podcast – glad we could help out with the CRP issue. I actually agree with you about the minimal evidence for “aggressive” control – and by that I assume you mean below 135/80. Definitely the evidence is minimal in proportion to how “aggressively” many clinicians tell us to get it down. Mike and I will be recording a podcast on this exact issue (at least diabetes and tight blood pressure control) in the next couple of weeks and the podcast should be released sometime in the next month or so. We do plan to do a proteinuria podcast in the next 6-8 weeks. So please keep listening. Thanks again. And if you can’t wait that long, nevermind.
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