From the Guidelines
Treatment for elevated high-sensitivity C-reactive protein (hs-CRP) should focus on addressing the underlying inflammation through lifestyle modifications and, in some cases, medication, with the goal of reducing cardiovascular risk and improving quality of life. According to the most recent and highest quality study 1, the measurement of hs-CRP may be useful in identifying patients at increased risk of stroke, and treatment with statins to decrease stroke risk might be considered.
Lifestyle Modifications
- Regular exercise (30 minutes of moderate activity most days)
- Adopt a Mediterranean or anti-inflammatory diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids
- Maintain a healthy weight
- Quit smoking and limit alcohol consumption
Medication
- For those with cardiovascular risk factors and elevated hs-CRP, statins like rosuvastatin (20mg daily) or atorvastatin (40mg daily) may be recommended, as they both lower cholesterol and reduce inflammation 1
- Low-dose aspirin (81mg daily) might be suggested for some patients with cardiovascular risk
Management of Underlying Conditions
- Manage any underlying conditions like autoimmune disorders or infections that could be causing inflammation
- Regular follow-up testing every 3-6 months helps monitor progress
These interventions work by reducing inflammatory processes in the body, which hs-CRP measures. The goal is to bring levels below 1 mg/L, as higher levels indicate increased cardiovascular risk. It is essential to note that the benefits of treatment based on hs-CRP levels remain uncertain, and clinical judgment is required to adjust risk within this risk category by measurement of hs-CRP 1.
From the Research
Treatment for Elevated High Sensitivity CRP
Elevated high sensitivity CRP (hs-CRP) is a marker of inflammation that predicts incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death among healthy individuals with no history of cardiovascular disease, and recurrent events and death in patients with acute or stable coronary syndromes 2.
Statin Therapy
- Statins have been shown to reduce the serum levels of hs-CRP and CRP in patients with cardiovascular diseases (CVDs) 3.
- The reduction of CRP levels by statins should be interpreted as a reduction of inflammatory burden, and its clinical benefits could be more interesting in secondary prevention 4.
- Atorvastatin, a type of statin, reduces plasma inflammatory and oxidant biomarkers, including CRP, in patients with risk of atherosclerotic cardiovascular disease 5.
Clinical Importance
- hs-CRP levels of less than 1 to 3, and greater than 3 mg/L are associated with lower, moderate, and higher cardiovascular risks, respectively 2.
- Inflammation assessed by high-sensitivity CRP was a stronger predictor for risk of future cardiovascular events and death than cholesterol assessed by low-density lipoprotein cholesterol (LDLC) among patients receiving contemporary statins 6.
Treatment Options
- Statin therapy, particularly high-intensity statin treatment, can reduce the serum levels of hs-CRP and CRP in patients with CVDs 3.
- Moderate- to high-intensity atorvastatin use reduces plasma oxidative stress and inflammation, regardless of atherosclerotic cardiovascular disease (ASCVD) risk and independent of its lipid-lowering effect 5.