hsCRP, Low Level of Inflammation and Heart Disease

The Biomarker Handbook is a curated series that seeks to provide readers with insights on each biomarker we cover in our blood test packages and its relation to our body.

According to the World Health Organization (WHO), heart disease accounts for about 31% of deaths globally– which equates to 17.7 million people. That’s a staggering number! One way to reduce the risk of getting heart disease is to adhere to a healthy lifestyle, get tested regularly for risk factors of heart disease, and manage these proactively. High-sensitivity C-reactive protein (hsCRP) is one such test that can tell you if you have an elevated risk for heart disease.

Definition of hsCRP

C-reactive protein (CRP) is a substance produced by the liver as a response to inflammation.

Elevated levels of CRP indicates the presence of inflammation. While standard CRP test checks for inflammation, infections, and some medical conditions, hsCRP is a more sensitive test that is used to evaluate the risk of heart disease. Low levels of inflammation in your blood are associated with atherosclerosis– which is the plaque build up in your arteries with narrowing of the walls, thereby reducing the blood supply– and heart disease.

Tracking Your hsCRP

The Ministry of Health in Singapore does recommend that all individuals with a 10-year heart disease risk of 5% or above be tested for hsCRP. As a general rule, anyone who has any risk factor for heart disease (hypertension, diabetes, obesity, lipidemia or smoker) will benefit from knowing their hsCRP level, and manage accordingly.

Your doctor will advise you to fast 9 to 12 hours prior to the test if the analysis includes lipid profile too. An important thing to remember is that you should be healthy at the time of sample collection. This means that you must not have had recent illnesses, infections, inflammation, or tissue injuries. This is because these conditions will raise the CRP level, thus making the result not useful in determining your risk of heart disease.

High hsCRP levels in otherwise healthy individuals indicate elevated risk for cardiovascular conditions such as stroke, heart attack, sudden cardiac death, and peripheral arterial disease, even when cholesterol levels are within a healthy range. The hsCRP test results show the quantity of this protein in your body and indicate your risk level (for heart disease) as follows:

  • Low risk: less than0 mg/l
  • Average risk: 1.0-3.0 mg/l
  • High risk: more than 0 mg/l
  • Very high risk: more than 10 mg/l

When the hsCRP level is less than 3 mg/l, the test does not need to be repeated. However, when above the stipulated value of 3 mg/l, it is necessary to repeat the test about two weeks later when you are in a stable state, and free of infection and illness. After the repeat test, the doctor takes the lower value as the true hsCRP level.

Signs and Symptoms to Watch Out For

Chronic low-grade inflammation is closely associated with atherosclerosis, or a build-up of plaque in blood vessels and can lead to stroke, heart attack, and other problems. Increased levels of LDL (the “bad” cholesterol) have been shown to propel atherosclerosis.

Since hsCRP is a non-specific test, there are no signs and symptoms that are associated with elevated values of this biomarker. After all, the test detects the presence of inflammation. Actual signs and symptoms would depend on the underlying condition that causes CRP levels to rise.

Risk Factors for Having Elevated hsCRP

Tracking CRP levels allows you to be one step ahead and prevent potentially serious complications. Risk factors that increase your chances of having higher hsCRP values are:

  • Obesity
  • Genetics
  • Sedentary lifestyle or lack of physical activity
  • Emotional stress
  • Exposure to environmental toxins, e.g., second-hand smoking
  • Unhealthy diet or excessive consumption of refined, processed, and manufactured foods

Ways to Balance hsCRP Levels

Statistics show 16 people die from cardiovascular disease in Singapore every day. In 2015, about 29.6% of deaths occurred due to cardiovascular conditions, such as heart attack and stroke. This means that approximately 1 in 3 deaths in Singapore is a result of cardiovascular disease. Malaysia is in a similar situation too.

Due to the high prevalence of cardiovascular disease, tracking hsCRP becomes even more critical. If test results show that levels of CRP are indeed elevated, there’s a lot you can do to change that. A healthy lifestyle is the best and safest way to lower hsCRP and decrease the risk of heart disease. Instead of eating unhealthy foods, you should opt for a well-balanced diet, rich in anti-inflammatory foods such as fruits, vegetables, and Omega-3 fatty acids. Keep your weight in a healthy range by combining a nutritious diet with regular physical activity. Instead of letting stress accumulate, take some time off for yourself and do activities you enjoy. Consult your doctor about vitamins and supplements that you could take if you lack essential nutrients.

Based on the underlying condition, your doctor may prescribe medications such as statins, but he or she may also advise you to take aspirin.

When Should You See the Doctor?

If you have an elevated hsCRP, it is wise to see your doctor to assess the significance. Your doctor will ensure that you were healthy during blood taking and not suffering from any illness that can elevate the inflammatory marker of CRP. Your doctor will also follow up with a repeat testing and perform a full metabolic screening.


Cardiovascular disease develops over time and is on a continuum that begins with poor lifestyle choices and ends in heart disease and possibly death. One way to check whether you’re at an elevated risk for cardiovascular disease is to do an hsCRP test. Consult your doctor about this test, especially if you are overweight, have a history of heart disease in your family, or lead a sedentary lifestyle.

Take a proactive approach to your health: many diseases are caused by lifestyle choices, and they can be avoided or delayed. Live a healthy life!

If you want to find out more about hsCRP and how to maintain healthy levels, take a look at our lifestyle article here!

Interested in other biomarkers? Check out the rest of The Biomarker Handbook.

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