C-Reactive Protein Test (CRP) (cont.)

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

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

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

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 2 separate CRP levels drawn 2 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 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 (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 the glucose their lowering affects.

Medically Reviewed by a Doctor on 2/19/2014

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