How To Determine Whether You Should be Tested for C-Reactive Protein

C-Reactive Protein is a protein found in the blood.  C-Reactive Protein is produced by the body during inflammation, which is the body's natural response to many conditions ranging from injury to infection.  Inflammation is now also believed to contribute to the start and continuation of cardiovascular disease.  Thus an elevated C-Reactive Protein count correlates with an increased risk for a stroke, heart attack and vascular disease.  The test for C-Reactive Protein is a simple blood test that does not require fasting.  A high sensitivity C-Reactive Protein test (hs-CRP) is now widely available.  Here are a few points to consider as you decide whether you should be tested for C-Reactive Protein:

  1. High levels of C-Reactive Protein in the blood consistently predict new coronary events in patients with existing coronary angina and a history of a previous heart attack.  High C-Reactive Protein levels are also associated with a decreased survival rate for this same group.

  • A high C-Reactive Protein level increases the risk that an artery will recluse (restenosis) after it's been opened by angioplasty.
  • High levels of C-Reactive Protein in the blood predict the onset and recurrence of stroke and peripheral vascular disease. 
  • So if you have any type of pre-existing cardiovascular condition, it seems pretty clear that you should get tested for C-Reactive Protein.  What if you don't have an existing cardiovascular condition?  Should you still get tested for C-Reactive Protein?

    1. Most studies agree that the higher the C-Reactive Protein level, the more likely that a person will suffer a heart attack.  These studies have been done using men, women, and the elderly.   Although the definitive association between high C-Reactive Protein levels and new cardiovascular events hasn't yet been decided upon, the evidence is strong that high C-Reactive Protein levels correlate with new cardiovascular events.
    2. Risk factors for cardiovascular events include family history of heart trouble, high blood pressure, high cholesterol, and smoking and diabetes.  If you have at least one or two risk factors, you should be tested.  For adults without a history of heart disease or diabetes, the American Heart Association has an online risk assessment using information from the Framingham Heart Study.  If your risk is low, they recommend no testing, but if your risk is intermediate or higher, they suggest a C-Reactive Protein test to help direct further evaluation and therapy.
    3. C-Reactive Protein level are considered high if they are greater than 3.0 mg/L, intermediate if the levels are between 1.0-2.9 mg/L, and low if below 1.0 mg/L.
    4. Remember that inflammation can occur in the body for many different reasons.  If, for example,you have recently had a flare-up of arthritis or an infection, you may have an elevated C-Reactive Protein level.   Be sure to tell your doctors about any health condition you may have that could affect your C-Reactive Protein level.
    5. The one great advantage of C-Reactive Protein testing is its ability to detect increased risk among apparently healthy people.

    Remember that if your C-Reactive Protein level is elevated, you will need to take active steps to reduce it.  This means major lifestyle changes, such as exercising regularly, quitting cigarettes and alcohol, controlling high blood pressure and diabetes, and losing weight.   You may also be prescribed statin drugs, ACE inhibitors and/or antithrombotic medications at dosages your doctor will determine.  A C-Reactive Protein test may give you the peace of mind of knowing whether you are actually in jeopardy of a heart attack or stroke, and if so, what you can do to minimize your risk.

     

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