When we calculate our risks for heart disease, a certain set of numbers comes immediately to mind: our blood pressure, “good” and
“bad” cholesterol levels, weight, waist
measurement and BMI, or body-mass index. But there is another number doctors
may use to identify potential heart disease—our CRP, or C-reactive protein
level.
CRP is a protein produced by the liver. Its presence indicates
there is inflammation (swelling) throughout the body. Inflammation is the body’s normal response to fever,
injury and infection. Since inflammation is also present when arteries of the
heart begin to get clogged with cholesterol plaques that restrict blood flow,
high levels of CRP may indicate heart disease. CRP has also been linked to
heart attack, stroke and risk for the reclosing of an artery that has been treated with angioplasty.
You may have heard reports in the popular media that say CRP
is an even more important indicator of heart disease than other risk factors,
including cholesterol and blood pressure levels. Some suggest that everyone over
30 should request a CRP blood test as part of their routine physical. Many of
the leading medical authorities, however, do not agree about the value of CRP
testing.
According to the Mayo Clinic, a CRP blood test isn’t right for everyone. That’s because while a high CRP level may be a risk factor for heart disease, test
results are not specific. The test can’t identify where the inflammation is
located in your body, so it could be somewhere other than your heart. High levels
of CRP can also indicate autoimmune conditions, such
as rheumatoid arthritis.
CRP testing alone will not determine your risk for heart
disease, but it may be a valuable tool, when combined with other blood tests
and heart risk factors in creating a total picture of your heart health. Other important indicators include
lifestyle choice (including smoking), family history and current health status.
The American Heart Association does not yet recommend CRP
screening for the general public. Rather, it finds that CRP testing is most
useful for people known to have an intermediate risk for heart disease—those
who have a 10 to 20 percent chance of dying from a heart attack within 10
years. The American Heart Association says CRP testing is not necessary for
those at low risk, and that people at high risk should seek treatment regardless
of their CRP levels.
Whether a high
CRP level actually increases heart risk or just reflects the inflammation caused
by other risk factors is still unknown. If your CRP levels are elevated, your
doctor will recommend the same lifestyle changes you should make if you have high
cholesterol or other heart-risk factors. These include increasing your level of
activity, not smoking, losing weight, watching your diet and controlling your
blood pressure. Medications used to treat CRP are the same as those used to
lower cholesterol levels.
If you are
concerned about your CRP level, talk with your primary care physician or
cardiologist.