What It Means to Have High C-Reactive Protein Levels

When c-reactive protein (CRP) is high, it's a sign of inflammation in the body. What constitutes a "high" level varies from person to person, but a reading of 2 milligrams per liter or above is often considered a dangerous CRP level and puts you at risk for a heart attack.

In addition to being associated with coronary artery disease (CAD), CRP is also related to complications from COVID-19, arthritis, and other conditions.

This article explains what it means for your c-reactive protein to be elevated. It explains CRP blood tests, possible causes for high CRP levels, and the medication and lifestyle changes that may be used to treat it.

CRP Blood Tests

Healthcare providers don't routinely test CRP like they do other things. Most experts do not recommend doing so, including the United States Preventive Services Task Force.

You may have your CRP levels checked if your healthcare provider thinks you could have an infection or another inflammation-causing condition. And if you don't have any obvious symptoms, a high CRP level might take you by surprise.

The CRP produced in the liver is a response to the activity of white blood cells that fight infection and inflammation in the body. Their heightened activity causes more CRP to be made, making it a biomarker for inflammation that can be detected by a blood test.

In most healthy adults, the c-reactive protein normal range is 0.3 milligrams per deciliter (mg/dL) or less, but with autoimmune conditions such as lupus and rheumatoid arthritis, that may be the case even if inflammation is present. Other values include:

• Between 0.3 mg/dL and 1.0 mg/dL, considered mildly elevated
• Between 1 mg/dL and 10 mg/dL, considered moderately elevated
• Above 10 mg/dL, considered to be highly elevated

What Elevated CRP Levels Mean

When CRP levels remain elevated for a long time, it can indicate chronic inflammation of the blood vessels. This type of low-grade inflammation contributes to the deposit of fat and other substances in the artery walls, a condition called atherosclerosis.

This build-up can narrow the arteries that feed the heart blood, causing coronary artery disease (CAD). Over time, heart attack, stroke, or heart failure can occur. This is true even for those with elevated CRP levels who have no obvious symptoms or signs of active inflammation.

Inflammation is an important contributor to atherosclerosis and elevated CRP is associated with an increased risk of CAD. A study of 376 people found that 210 of them diagnosed with CAD all had elevated CRP levels when compared with 166 people who did not have CAD.

The CRP level increased in step with the degree of blood vessel damage evaluated by coronary angiography, an imaging test used to visualize blood flow through the heart.

Addressing Your Risk Factors

A number of risk factors may contribute to CRP levels, and there may be benefits to taking steps to reduce your CRP levels. Treatment aimed at lowering CRP levels may reduce cardiovascular risk, but researchers are still working to understand these relationships.

Elevated CRP levels are almost always associated with other risk factors for heart disease, including:

• Smoking
• Obesity
• Inactive lifestyle
• High cholesterol
• High blood pressure
• Diabetes
• Metabolic syndrome (a combination of high blood pressure, high blood sugar, abnormal lipid levels, and excess abdominal fat)

Talk to your healthcare provider about your heart disease risk factors and what can be done to address them and your CRP levels.

This may involve habit changes, weight loss efforts, and/or medication.

C-Reactive Protein Treatment

While it is still uncertain how important it is to reduce elevated CRP, experts have identified several ways of doing so.

Lifestyle Changes

You don't necessarily need medicine to lower your levels of CRP. Taking steps to make your lifestyle healthier can also help.

Ways to reduce your CRP without drugs include:

• Increasing your aerobic exercise (e.g, running, fast walking, cycling)
• Quitting smoking
• Losing weight
• Eating a heart-healthy diet

Some of these strategies can also reduce certain heart disease risk factors, such as obesity and high blood pressure. You also may wish to reduce stress and anxiety. Some studies have found higher CRP levels in males with anxiety disorder, although it's not clear that anxiety causes high CRP levels.

Statins

Statins are drugs that lower cholesterol. Studies have shown that they can reduce CRP levels by 13% to 50%.

Statins can also substantially reduce the risk of heart attack and stroke in even healthy-appearing patients whose CRP levels are high.

Statins shown to bring down CRP levels and reduce related cardiac risks include:

• Crestor (rosuvastatin)
• Lipitor (atorvastatin)
• Mevacor (lovastatin)
• Pravachol (pravastatin)
• Zocor (simvastatin)

If you have high CRP levels, especially if you have one or more additional risk factors for heart disease, you should discuss the option of taking a statin drug with your healthcare provider.

Does Aspirin Help?

Aspirin does not specifically reduce levels of CRP. However, daily aspirin therapy can be used as a heart attack and stroke prevention measure, but the risks of taking aspirin for prevention may outweigh the benefits.

Those with elevated CRP may benefit from aspirin therapy more than people whose CRP levels are normal. It may be recommended for some people with elevated CRP who are at a higher risk of heart disease or who have already experienced one of these consequences.

Aspirin therapy isn't for everyone. Always talk to your healthcare provider before taking low-dose aspirin for daily therapy.

Summary

Elevated CRP levels indicate there is inflammation in the body.

Inflammation cannot only be an indicator of issues like an infection or arthritis, but a contributing factor for heart concerns like hardening of the arteries.

It remains unknown whether CRP itself increases cardiovascular risk. It could be that it merely reflects the vascular injury and inflammation that results from other risk factors.

Regardless, elevated CRP must be taken seriously as it is associated with conditions that affect the health of your heart and the supply of blood to the rest of your body.