Inflammation, Heart Disease and Stroke: The Role of C-Reactive Protein
How does inflammation relate to heart disease and stroke risk?
“Inflammation” is the process by which the body responds to injury. Laboratory evidence and findings from clinical and population studies suggest that inflammation is important in atherosclerosis (ath”er-o-skleh-RO’sis). This is the process in which fatty deposits build up in the lining of arteries.
C-reactive protein (CRP) is one of the acute phase proteins that increase during systemic inflammation. It’s been suggested that testing CRP levels in the blood may be a new way to assess cardiovascular disease risk. A high sensitivity assay for CRP test (hs-CRP) is now widely available.
The American Association and the Centers for Disease Control and Prevention recently published a joint scientific statement about using inflammatory markers in clinical and public health practice. This statement was developed after systematically reviewing the evidence of association between inflammatory markers (mainly CRP) and coronary heart disease and stroke.
What’s the role of CRP in predicting recurrent cardiovascular and stroke events?
A growing number of studies have examined whether hs-CRP can predict recurrent cardiovascular disease and stroke and death in different settings. High levels of hs-CRP consistently predict new coronary events in patients with unstable angina and acute myocardial infarction (heart attack). Higher hs-CRP levels also are associated with lower survival rate of these people. Many studies suggested that after adjusting for other prognostic factors, hs-CRP was still useful as a risk predictor.
Recent studies also suggest that higher levels of hs-CRP may increase the risk that an artery will reclose after it’s been opened by balloon angioplasty. High levels of hs-CRP in the blood seem to predict prognosis and recurrent events in patients with stroke and peripheral arterial disease.
Should I have my CRP level measured?
If a person’s cardiovascular risk score — judged by global risk assessment — is low (the possibility of developing cardiovascular disease is less than 10 percent in 10 years, no test is immediately warranted. If the risk score is in the intermediate range (10-20 percent in 10 years), such a test can help predict a cardiovascular and stroke event and help direct further evaluation and therapy. However, the benefits of such therapy based on this strategy remain uncertain. A person with a high risk score (greater than 20 percent in 10 years) or established heart disease or stroke should be treated intensively regardless of hs-CRP levels.
What is the normal range of hs-CRP level?
- If hs-CRP level is lower than 1.0 mg/L, a person has a low risk of developing cardiovascular disease.
- If hs-CRP is between 1.0 and 3.0 mg/L, a person has an average risk.
- If hs-CRP is higher than 3.0 mg/L, a person is at high risk.
If, after repeated testing, patients have persistently unexplained, markedly elevated hs-CRP (greater than 10.0 mg/L), other evaluation should be considered to exclude noncardiovascular causes.
Checklists for Lowering Your Cholesterol
Eating to lower your cholesterol
It's fairly easy to lower your blood cholesterol.
Just eat more foods low in saturated fat and cholesterol and cut down on high-fat ones, especially those high in saturated fats. Here are some simple daily guidelines:
- Watch your caloric intake by eating a wide variety of foods low in saturated fat and cholesterol.
- Eat at least five servings of fruits and vegetables every day.
- Eat six or more servings of cereals, breads, pasta and other whole-grain products.
- Eat fish, poultry without skin and leaner cuts of meat instead of fatty ones.
- Eat fat-free or 1% milk dairy products rather than whole-milk dairy products.
- Enjoy 30–60 minutes of vigorous activities on most (or all) days of the week.
- Maintain a healthy weight.
Please visit Delicious Decisions for more information about great recipes, tips for eating out and our Recipe Quick Find tool.
Getting started on an exercise program - Wear comfortable clothes and sneakers or flat shoes with laces.
- Start slowly. Gradually build up to 30 minutes of activity on most or all days of the week (or whatever your doctor recommends). If you don't have a full 30 minutes, try two 15-minute sessions to meet your goal.
- Exercise at the same time of day so it becomes a regular part of your lifestyle. For example, you might walk every weekday from noon to 12:30 p.m.
- Drink a cup of water before, during and after exercising (but check with your doctor, because some people need to limit their fluid intake).
- Ask family and friends to join you. You'll be more likely to stick with it.
- Note your activities on a calendar or in a logbook. Write down the distance or length of time of your activity and how you feel after each session. If you miss a day, plan a make-up day or add 10–15 minutes to your next session.
- Use variety to keep your interest up. Walk one day, swim the next time, then go for a bike ride on the weekend.
- Join an exercise group, health club or the YMCA. Many churches and senior centers offer exercise programs, too. (Get your doctor's permission first.)
- Look for chances to be more active during the day. Walk the mall before shopping, choose a flight of stairs over an escalator, or take 10–15 minute walking breaks while watching TV or sitting for some other activity.
- Don't get discouraged if you stop for awhile. Get started again gradually and work up to your old pace.
- Don't engage in any activity that causes chest pain, shortness of breath, dizziness or lightheadedness. If these happen, stop what you're doing right away.
- Don't exercise right after meals, when it's very hot or humid, or when you just don't feel up to it.
Please visit Just Move for more information on getting more physically active.
Making lifestyle changes
- Ask your physician or healthcare professional to help you with nutrition and physical activity advice.
- Learn to read food labels so you'll be able to tell how much fat, sodium and other ingredients are in your diet.
- Keep a diary of all your nutrition and physical activity efforts. Seeing your successes written down will encourage you to continue your good habits.
- If you don't feel like you're making progress, talk to your physician and ask why your progress is slow.
- If you're having trouble giving up smoking, ask your doctor if you can take a smoking cessation drug to help.
- Become an active participant in making treatment decisions and solving problems that keep you from following the doctor's orders.
“Therefore God exalted him to the highest place and gave him the name that is above every name, that at the name of Jesus every knee should bow, in heaven and on earth and under the earth, and every tongue confess that Jesus Christ is Lord, to the glory of God the Father.” (Philippians 2:9-11)
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