While cholesterol levels are commonly used to assess heart disease risk, research shows that another blood marker—high-sensitivity C-reactive protein (hs-CRP)—may offer even more powerful insight, particularly when it comes to predicting heart attacks caused by silent inflammation.
Heart attack risk and why the hs-CRP test helps predict it early
C-reactive protein (CRP) is a substance produced by the liver in response to inflammation in the body. The high-sensitivity CRP (hs-CRP) test measures very low levels of CRP, helping detect chronic inflammation that may not cause obvious symptoms. Inflammation plays a central role in the development of atherosclerosis—a condition in which arteries become narrowed or blocked due to plaque buildup—raising the risk of heart attacks and strokes.According to the American Heart Association (AHA), individuals with elevated hs-CRP levels, even if their cholesterol appears normal, may still face significantly higher cardiovascular risk.
Study confirms: hs-CRP predicts heart attack risk
A major study called the JUPITER trial, published in the New England Journal of Medicine in 2008, provided strong evidence that measuring hs-CRP levels can help identify people at risk for heart attacks—even if their cholesterol is normal.In this large-scale study involving over 17,000 participants with normal LDL cholesterol but elevated hs-CRP levels, researchers found that treatment with a statin (rosuvastatin) cut the risk of heart attack by 54% and stroke by 48% compared to placebo. This demonstrated that inflammation—not just cholesterol—plays a critical role in cardiovascular risk.
Interpreting hs-CRP levels and heart attack risk categories
According to guidelines, hs-CRP levels fall into three major risk categories:
- <1.0 mg/L – Low cardiovascular risk
- 1.0–3.0 mg/L – Moderate risk
- >3.0 mg/L – High risk
Even in the absence of high LDL cholesterol, values above 3.0 mg/L suggest a greater likelihood of vascular inflammation and arterial damage.
How to lower hs-CRP and reduce heart risk
Several lifestyle and medical interventions can help reduce hs-CRP levels:
- Adopt an anti-inflammatory diet (rich in fruits, vegetables, whole grains, and omega-3s)
- Exercise regularly (150+ minutes/week of moderate activity)
- Quit smoking
- Maintain a healthy weight
- Consider statin therapy if advised by a physician—particularly if both cholesterol and CRP are high
Statins have been shown not only to lower LDL cholesterol but also to reduce inflammation markers like hs-CRP, as highlighted in the JUPITER trial.Cholesterol is just one piece of the cardiovascular puzzle. Measuring hs-CRP provides insight into hidden inflammation, helping to identify individuals at risk for heart disease—even if their standard lipid panel looks normal. For a more comprehensive cardiovascular assessment, ask your healthcare provider about getting an hs-CRP test alongside traditional cholesterol and Lipoprotein(a) testing.Also Read: Strength training for diabetes: How weight lifting helps manage type 2 diabetes
