C-Reactive Protein (CRP)

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

How can C-reactive protein (CRP) values predict potential heart disease?

According to the American Heart Association (AHA) and the CDC, the following guidelines are recommended for the assessment of cardiovascular risk in regards to hs-CRP levels:

  • Low risk for cardiovascular disease if hs-CRP is 1 milligram (mg) per liter or less
  • Moderate risk for cardiovascular disease if hs-CRP is between 1 and 3 mg per liter
  • High risk for cardiovascular disease if hs-CRP greater than 3 mg per liter

CRP level of greater than 10 mg per liter may be seen in an acute plaque rupture such as, a heart attack or stroke, provided there is no other explanation for the elevated level (other inflammatory or infectious process).

What is the normal range for C-reactive protein?

C-reactive protein is a marker of inflammation and is typically not detected in the blood unless some degree of inflammation is present in the body.

Should I have my C-reactive protein (CRP) level tested?

Checking the CRP level for the entire adult population is not recommended.

Some experts recommend checking the serum CRP level routinely along with the cholesterol level; however, although this is not widely accepted. Ideally, for cardiac risk testing, it is advisable to use the average between two separate CRP levels drawn two weeks part.

More importantly, the CRP level can provide additional information about an individual's cardiovascular risk in conjunction with other known cardiac risk factors, such as, diabetes mellitus, high blood pressure, high cholesterol, obesity, age, and smoking.

What are signs and symptoms of an elevated C-reactive protein level?

There are no signs or symptoms that are specific for an elevated C-reactive protein level, because it is not a specific test. Signs or symptoms, if present, would depend on the underlying inflammatory condition that is the cause of the elevated CRP level.

What is the treatment for high C-reactive protein (CRP)?

The treatment of an elevated CRP in the context of cardiovascular disease, in and of itself, may be meaningless. Instead, appropriate treatment and prevention of the underlying risks and conditions need to be the primary focus of cardiovascular risk reduction.

The most effective and reliable ways to reduce many cardiac factors are regular exercise, balanced diet, and cigarette smoking cessation. In individuals with elevated cholesterol levels who do not reach their target cholesterol level with diet modification and proper exercise, cholesterol lowering medication may be advised by their treating physicians. Statin drugs (such as simvastatin [Zocor], atorvastatin [Lipitor], etc.) are in the forefront of the recommended cholesterol-lowering agents. Lowering of CRP may be seen with the use of statin drugs even without significant improvement of the cholesterol profile.

Reduction of CRP level has also been noted in individuals with known cardiovascular disease who begin aspirin therapy. In those without known cardiovascular disease or significant risk factors for it, aspirin use is not generally recommended. Some diabetic medications (thiazolidinediones) have also been shown to reduce CRP levels in people with or without diabetes mellitus. This effect was seen independent of their glucose-lowering affects.

Medically Reviewed by a Doctor on 11/11/2016

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