Inflammatory markers and cardiovascular disease (The Health, Aging and Body Composition [Health ABC] Study)

Am J Cardiol. 2003 Sep 1;92(5):522-8. doi: 10.1016/s0002-9149(03)00718-5.


This study investigates the association of several inflammatory markers with subclinical and clinical cardiovascular disease in older men and women. Data are from the baseline assessment of 3,045 well-functioning persons aged 70 to 79 years, participating in the Health, Aging and Body Composition study. The study sample was divided into 3 groups: "cardiovascular disease" (diagnosis of congestive heart failure, coronary artery disease, peripheral artery disease, or stroke), "subclinical cardiovascular disease" (positive findings on the Rose questionnaire for angina or claudication, ankle-brachial index <0.9, or electrocardiographic abnormalities), and "no cardiovascular disease." Serum levels of interleukin (IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-alpha, and the soluble receptors IL-6 soluble receptor, IL-2 soluble receptor, TNF soluble receptor I, and TNF soluble receptor II were assessed. Of those with IL-6 levels in the highest compared with the lowest tertile, the odds ratio (OR) for subclinical cardiovascular disease was 1.58 (95% confidence interval [CI] 1.26 to 1.97) and for clinical cardiovascular disease was 2.35 (95% CI 1.79 to 3.09). A similar association was found for TNF-alpha (OR 1.48, 95% CI 1.16 to 1.88 and OR 2.05, 95% CI 1.55 to 2.72, respectively). In adjusted analyses, CRP was not significantly associated with overall subclinical or clinical cardiovascular disease, although additional analyses did find a strong specific association between CRP and congestive heart failure (OR 1.64, 95% CI 1.11 to 2.41). Of the soluble cytokine receptors, only TNF soluble receptor I showed a significant association with clinical cardiovascular disease. Thus, our findings suggest an important role for IL-6 and TNF-alpha in clinical as well as subclinical cardiovascular disease. In this study, CRP had a weaker association with cardiovascular disease than the cytokines.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Aged
  • Antigens, CD / blood
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / classification
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / immunology
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Inflammation
  • Interleukin-6 / blood*
  • Logistic Models
  • Male
  • Pennsylvania / epidemiology
  • Predictive Value of Tests
  • Prospective Studies
  • Receptors, Interleukin-2 / blood
  • Receptors, Interleukin-6 / blood
  • Receptors, Tumor Necrosis Factor / blood
  • Receptors, Tumor Necrosis Factor, Type I
  • Receptors, Tumor Necrosis Factor, Type II
  • Risk Factors
  • Tennessee / epidemiology
  • Tumor Necrosis Factor-alpha / metabolism*


  • Antigens, CD
  • Biomarkers
  • Interleukin-6
  • Receptors, Interleukin-2
  • Receptors, Interleukin-6
  • Receptors, Tumor Necrosis Factor
  • Receptors, Tumor Necrosis Factor, Type I
  • Receptors, Tumor Necrosis Factor, Type II
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein