From the Guidelines
If you have elevated C-reactive protein (CRP) levels, you should consult with your healthcare provider to determine the underlying cause and appropriate treatment, as elevated CRP is a marker of inflammation that can indicate various conditions including infections, autoimmune disorders, or cardiovascular disease 1.
Understanding CRP
CRP is a protein that increases in the blood when there is inflammation or infection, and it is used as a marker to assess the level of inflammation in the body. Elevated CRP levels have been associated with an increased risk of cardiovascular disease, among other conditions.
Determining the Cause
To address elevated CRP levels, it is crucial to identify the underlying cause. This may involve additional tests to rule out infections, autoimmune disorders, or other conditions that could be contributing to the inflammation.
Treatment Approaches
Treatment typically focuses on addressing the underlying condition rather than the CRP level itself. This might include:
- Antibiotics for bacterial infections
- Anti-inflammatory medications like ibuprofen (400-800mg every 6-8 hours) or naproxen (250-500mg twice daily) for inflammatory conditions
- Statins such as atorvastatin (10-80mg daily) if the elevation is related to cardiovascular risk, as supported by studies like the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) 1
Lifestyle Modifications
Lifestyle modifications can also play a significant role in reducing inflammation, including:
- Regular exercise, aiming for 150 minutes of moderate activity weekly
- Maintaining a healthy weight
- Following an anti-inflammatory diet rich in fruits, vegetables, and omega-3 fatty acids
- Getting adequate sleep, 7-9 hours nightly
- Managing stress
Monitoring CRP Levels
CRP levels should be monitored periodically to assess treatment effectiveness and disease progression. The importance of treating elevated CRP lies in reducing chronic inflammation, which can damage tissues and increase the risk for serious health problems if left unaddressed 1.
Clinical Considerations
It's essential to consider the clinical context and the patient's overall risk profile when interpreting CRP levels. The American Heart Association provides guidelines for the use of inflammatory markers, including CRP, in clinical practice, emphasizing the importance of considering these markers within the context of overall cardiovascular risk assessment 1.
Given the most recent and highest quality evidence, the management of elevated CRP should prioritize identifying and treating the underlying cause, along with lifestyle modifications to reduce inflammation, under the guidance of a healthcare provider 1.
From the Research
Elevated CRP Management
To manage elevated C-reactive protein (CRP) levels, several strategies can be employed, including:
- Therapeutic lowering of circulating CRP levels 2
- Use of CRP-lowering agents such as statins, angiotensin receptor blockers (ARBs), and antidiabetic agents 3
- Reduction of inflammation through the use of anti-inflammatory agents 4
- Modification of disease activity and inflammation through the use of disease-modifying anti-inflammatory drugs (DMARDs) such as methotrexate 5
CRP-Lowering Agents
Various agents have been shown to lower CRP levels, including:
- Statins, which have a pronounced CRP-lowering effect that is independent of their lipid-lowering activity 3
- ARBs, which have been shown to markedly reduce serum levels of CRP 3
- Antidiabetic agents such as rosiglitazone and pioglitazone, which reduce CRP levels 3
- Anti-inflammatory agents such as naproxen, which has been shown to decrease CRP levels in patients with rheumatoid arthritis 4
Disease Management
Elevated CRP levels are often associated with underlying diseases such as rheumatoid arthritis, cardiovascular disease, and cancer. Management of these diseases through the use of DMARDs, anti-inflammatory agents, and other therapies can help to reduce CRP levels and alleviate symptoms. For example:
- Methotrexate therapy has been shown to reduce disease activity and inflammation in patients with rheumatoid arthritis, resulting in decreased CRP levels 5
- CRP-based algorithms have been proposed to guide the use of antibiotics and reduce antibiotic treatment duration in patients with bacterial infections 6