Know your heart-healthy numbers – including CRP

“Know your numbers.” It’s a common theme surrounding heart health. Most doctors agree you should know your blood pressure, blood sugar and cholesterol so you can make changes to improve your health and reduce your risk of heart problems.

But there’s one more number people should be aware of: C-reactive protein (CRP).

CRP is a marker for inflammation in the body. It’s been shown that, when used in conjunction with cholesterol levels, it can help us better understand a person’s risk for heart disease. In fact, one analysis showed that the risk of a future heart event was more than 50 percent higher when CRP levels were over 3 mg/L.

Unfortunately, people often emphasize their cholesterol levels without considering any other factors. They think if their cholesterol is low, they are at low risk for heart disease. That may not always be the case. Knowing both your CRP and cholesterol levels is more powerful than knowing one alone.

Let’s take a closer look at how your CRP affects your heart risk. That way, the next time your doctor prepares to test your cholesterol, you can also ask about your CRP level.

What is CRP, and what does it tell us about heart health?

CRP is a ring-shaped protein produced in the liver in response to inflammation in the body. Inflammation is part of the body’s response to fighting infection. We all have a low level of inflammation at any given time. That’s normal and healthy.

While the exact role inflammation plays in heart disease is a topic of ongoing research, we do know that having a high level of inflammation over a long period of time creates heart risk. And we know we can measure inflammation in the body by testing CRP levels.

Checking your CRP involves a simple blood test. If you’re getting your cholesterol tested, we can use the same tube of blood. No extra needle sticks are necessary.

Your CRP level puts you in one of three categories:

  • Low risk: Less than 1 mg/L
  • Average risk: 1 to 3 mg/L
  • High risk: Greater than 3 mg/L

However, your CRP can’t tell us everything. It’s important to look at it in relation to your cholesterol, specifically low-density lipoprotein (LDL). LDL is considered the bad cholesterol because it collects in your arteries and can cause blockages. Your CRP modifies your LDL level.

Here’s how it works: If you have a low LDL but a high CRP, the high CRP reduces the benefit of a low LDL. You’re at increased risk. And it’s the same in reverse: If you have a high LDL but a very low CRP, that low CRP reduces the risk from the high LDL.

In fact, the American Heart Association and the Centers for Disease Control and Prevention say it’s reasonable to measure CRP as a part of heart disease risk assessment. It’s not considered mandatory, but patients and their doctors should discuss its potential benefits.

Once you know your numbers, there is a very simple online scoring tool you can use to predict your heart risk over the next 10 years.

How can you lower your CRP?

What causes a high CRP? It’s a combination of genetics, health and lifestyle factors, including:

  • Chronic inflammatory conditions such as rheumatoid arthritis, lupus, psoriasis and gum disease
  • Excess body fat
  • Low physical activity
  • Smoking

The good news is that there are many ways to lower your CRP. Most are the same things you should be doing to live a heart-healthy lifestyle: eat a healthy diet, exercise and quit smoking. If you have a chronic inflammatory condition, work with your doctor to manage it effectively.

Studies, including one I authored, have shown statins also can reduce CRP. Statins are a class of drugs typically prescribed to lower cholesterol levels and reduce the risk of heart attack and stroke. Current guidelines advise the use of statins for people with:

  • Known heart disease
  • Elevated levels of LDL cholesterol
  • Diabetes
  • An estimated 10-year risk of a heart event greater than 7.5 percent

And the JUPITER study showed statins could benefit otherwise healthy people with high CRP levels by cutting their risk of heart disease and death from heart disease by almost half. This would indicate we should take CRP into effect when assessing a person’s heart risk.

Who should get their CRP tested?

I recommend anyone who has their cholesterol checked to also have their CRP tested. As I said earlier, we can use the same blood draw; we simply check one more box for the lab to test.

Just like with cholesterol, the earlier we identify a high CRP levels, the more time we have to prevent potential heart problems through lifestyle changes and, if necessary, medical treatments.

CRP is simply one more way to optimize our understanding of someone’s heart risk. And high CRP is treatable! So the next time you’re in the doctor’s office, ask about your numbers. All of them.

Request an appointment to test your heart-health numbers.

Chief of Cardiology, MedStar Heart & Vascular Institute at MedStar Washington Hospital Center
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