Inflammation (swelling) of the arteries is a risk factor for cardiovascular disease. It has been linked to an increased risk of heart disease, heart attack, sudden death, stroke, and peripheral arterial disease. It has also been linked to an increased risk of restenosis, or the re-closing of an artery that has been treated with balloon angioplasty.
To see if your arteries are inflamed as a result of atherosclerosis, doctors can test your blood for C-reactive protein (CRP). The body produces CRP during the general process of inflammation. Therefore, CRP is a "marker" for inflammation, meaning its presence indicates an increased state of inflammation in the body.
CRP and cardiovascular disease risk
In studies involving large numbers of patients, CRP levels seem to be correlated with levels of cardiovascular risk. In fact, CRP seems to predict cardiovascular risk at least as well as cholesterol levels do. Data from the Physicians Health Study, a clinical trial involving 18,000 apparently healthy physicians, found that elevated levels of CRP were associated with a threefold increase in the risk of heart attack.
In the Harvard Women's Health Study, results of the CRP test were more accurate than cholesterol levels in predicting coronary problems. Twelve different markers of inflammation were studied in healthy, postmenopausal women. After three years, CRP was the strongest predictor of risk. Women in the group with the highest CRP levels were more than four times as likely to have died from coronary disease, or to have suffered a nonfatal heart attack or stroke. This group was also more likely to have required a cardiac procedure such as angioplasty (a procedure that opens clogged arteries with the use of a flexible tube) or bypass surgery than women in the group with the lowest levels.
How is CRP measured?
CRP is measured with a simple blood test, which can be done at the same time your cholesterol is checked. One such test is the high-sensitivity C-reactive protein (hs-CRP, also called ultra-sensitive CRP or us-CRP) test.
Risk is determined based on your test results.
How CRP is measured:
C-Reactive Protein
Less than 1.0 mg/L
1.0-2.9 mg/L
Greater than 3.0 mg/L
Risk for Cardiovascular Disease
Low
Intermediate
High
It's important to note that inflammation due to other conditions, such as an infection, illness, or a serious flare-up of arthritis, can raise CRP levels. Before getting the CRP test, tell your doctor what other medical conditions you have.
Should I have my CRP level tested?
The American Heart Association states hs-CRP may be useful in evaluating those at moderate risk and determining whether or not more intensive treatment is warranted. Those at high risk should be treated aggressively regardless of their hs-CRP level.
Having more of the following risk factors increases your risk of heart disease.
- A previous heart attack or stroke
- A family history of cardiovascular disease
- Elevated total and LDL cholesterol levels
- Low HDL level
- High blood pressure
- Being male or a post-menopausal woman
- Cigarette smoker
- Uncontrolled diabetes or high blood pressure
- Physical inactivity
- Obesity or being overweight
In addition, research suggests that it may be beneficial to have your CRP level checked if you are going to undergo a heart treatment such as angioplasty. Studies show that higher levels may increase the risk that the artery will close after it is opened by balloon angioplasty. Ask your doctor for specific guidelines regarding your situation.
What is the treatment for high CRP?
It is important for everyone to make these lifestyle changes to reduce your risk for cardiovascular disease, especially if your CRP level is intermediate or high:
- Eating a heart-healthy diet
- Reducing high cholesterol levels
- Maintaining a healthy weight
- Exercising regularly
- Managing diabetes and high blood pressure
- Quitting smoking or tobacco use
- Drinking less alcohol
The American Heart Association does not recommend hs-CRP testing as routine screening for people who are not at high risk for cardiovascular disease.
For those with an elevated CRP level, taking aspirin may provide protection from cardiovascular disease. Statins, the most commonly prescribed cholesterol-lowering drugs, may reduce CRP. Your doctor will prescribe the correct medications and dosage to treat your condition.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/1/2006...#12874
