What To Expect During The Test
A nurse or other healthcare professional will draw blood from a vein, usually on the inside of your elbow or the back of your hand.
First, they clean the skin over the vein with antiseptic. Next, they wrap an elastic band around your arm, causing your veins to bulge out slightly. The healthcare professional then inserts a small needle into the vein and collects your blood in a sterile vial.
After the healthcare professional collects your blood sample, they remove the elastic band around your arm and ask you to apply pressure to the puncture site with gauze. They may use tape or a bandage to hold the gauze in place.
How Can Low Moderate And Elevated C
According to the American Heart Association and the CDC, the following guidelines are recommended for the assessment of cardiovascular risk in regards to high-sensitivity C-reactive protein levels:
- Low risk for cardiovascular disease if hs-CRP is 1 milligram per liter or less
- Moderate risk for cardiovascular disease if hs-CRP is between 1 and 3 mg per liter
- High risk for cardiovascular disease if hs-CRP greater than 3 mg per liter
CRP level of greater than 10 mg per liter may be seen in an acute plaque rupture such as a heart attack or stroke, provided there is no other explanation for the elevated level .
- family history of heart disease.
According to recent studies, after adjusting for these traditional risk factors, elevated CRP level alone is unlikely to be a cause of cardiovascular disease.
Nevertheless, CRP may be used as a predictor of cardiovascular disease based on its correlation with the other known cardiac risk factors and their role in the formation of atherosclerosis. In individuals with some or all of these traditional risk factors, elevated CRP levels have been detected. Some data even suggest a trend of higher CRP elevation in the presence of a higher number of risk factors.
Are There Risks With The Test
There are no risks associated with this test other than routine issues that can occur with any blood test. The main issues
A small study from 2013 evaluated 100 people with cardiovascular risk factors. Researchers found that a CRP level over 10 mg/L was connected to a 4 percent risk of developing a fatal cardiovascular disease in 10 years.
If your doctor believes you may be at risk of heart disease or stroke, they may order a hs-CRP blood test alongside other tests.
Additionally, theres more recent research that suggests CRP may be used as a predictor of health outcomes related to chronic obstructive pulmonary disease .
If your doctor is concerned you are dealing with the symptoms of other inflammatory conditions besides cardiovascular issues, they may order a regular CRP test to diagnose, among other things:
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Whats The Link Between Crp And Cardiovascular Health
When inflammation becomes chronic, it leads to changes in your blood vessels making them more permeable to fat and cholesterol and leading to the formation of plaque on the blood vessel walls. This is why chronic inflammation can cause atherosclerosis and heart attacksÂ¹ and elevated levels of CRP are associated with an increased risk for cardiovascular disease.
Handling Of Hscrp Values Below Lower Limit Of Quantification
If hsCRP values were below the lower limit of quantification , a prespecified imputation rule was applied so that hsCRP values were imputed as LLoQ/2. In all three PIONEER trials, LLoQ was 0.1 mg/L and in SUSTAIN 3, it was 1.4 nmol/L . The proportion of values that were below LLoQ ranged from 00.19% at baseline to 00.7% at end-of-treatment.
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Conditions Linked To Elevated High
Elevated High-sensitivity C-Reactive Protein Screening levels can be an indicator of an increased risk of cardiovascular disease, including heart attack and stroke.
An elevated hsCRP will not indicate the cause of inflammation which can also be due to temporary, short-term conditions such as recent surgery, injury, illness or infection.
Elevated hsCRP can also be associated with inflammatory diseases such as rheumatoid arthritis or lupus.
Analytic Properties Of Hscrp Assays
Historically, CRP has been measured in clinical laboratories to monitor active infection. Although such assays are automated and reproducible, they have a lower detection limit of 3 to 8 mg/L and thus are not sensitive enough to detect the low-end variations required for prediction of vascular risk. Of various techniques used by investigators and manufacturers to improve the sensitivity of CRP assays, the most successful approach has been to amplify the light-scattering properties of the
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How Does Crp Relate To Cardiovascular Risk
Your level of C-reactive protein can be an indicator of how at risk you are for developing cardiovascular problems. This is because the development of atherosclerosis is associated with inflammation within the vessel walls. The result is higher levels of CRP in patients with atherosclerosis than in those without atherosclerosis.
The value of knowing CRP levels depends on whether you fall into one of three cardiovascular risk groups:
- Low risk because of low cholesterol levels and little history of risk factors that is, no diabetes, high blood pressure, or smoking, and no family history of heart attacks at an early age. Even a higher level of CRP will probably not put you at a level of risk that requires than lifestyle changes.
- Intermediate risk helpful to know CRP level, because it can provide missing piece of information for physician deciding next step in treatment
- High risk not essential to know your CRP, because you should already be combining aggressive treatment with lifestyle changes to lower your risk
Comparison Of Asthmatic Patients And Control Subjects
The characteristics and outcomes of the control subjects and two groups of patients with asthma are shown in table1. Sex distribution, smoking status, FEV1 and BMI did not differ among the three groups. The healthy control group was younger than the two asthmatic groups. FEV1/FVC and FEF2575% in the asthmatic groups were decreased compared with those in the control group. The number of sputum eosinophils was significantly increased in the ICS+ group compared to healthy controls, and disease duration in the ICS+ group was significantly longer than that in the ICS- group. Serum concentrations of hs-CRP were significantly increased in the ICS- group but not in the ICS+ group compared with healthy controls .
Relationship between serum high-sensitivity C-reactive protein levels and clinical or sputum indices in patients with asthma
In the ICS+ group, no significant correlation was found between serum hs-CRP levels and sputum or clinical indices . Atopic status did not affect hs-CRP levels in either the ICS+ group or the ICS- group .
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When Should You Have C
Checking the CRP level for the entire adult population is not recommended. Some experts recommend checking the serum CRP level routinely along with the cholesterol level however, although this is not widely accepted. Ideally, for cardiac risk testing, it is advisable to use the average between two separate CRP levels drawn two weeks part.
More importantly, the CRP level can provide additional information about an individual’s cardiovascular risk in conjunction with other known cardiac risk factors, such as,
- cholesterol-lowering medication.
People with elevated C-reactive protein levels may be advised by their treating doctors. Statin drugs are at the forefront of the recommended cholesterol-lowering agents. Lowering of CRP may be seen with the use of statin drugs even without significant improvement of the cholesterol profile.
Reduction of CRP level has also been noted in individuals with known cardiovascular disease who begin aspirin therapy. In those without known cardiovascular disease or significant risk factors for it, aspirin use is not generally recommended. Some diabetic medications have also been shown to reduce CRP levels in people with or without diabetes mellitus. This effect was seen independent of their glucose-lowering effects.
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 . 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.
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What Happens During A Crp Test
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This process usually takes less than five minutes.
What Should You Do If You Have High Crp
Lowering your CRP isnt a guaranteed way to lower your risk of cardiovascular or autoimmune disease.
Its important to know that high CRP is what doctors call a biomarker. A biomarker is a factor to keep in mind when analyzing a persons health, but not a stand-alone indicator of a particular diagnosis.
A 2015 study indicates that eating a nutritious, balanced diet including lots of fruits, vegetables, and fiber may help lower your CRP concentration.
If youre at high risk of cardiovascular disease and your test results show high CRP, your doctor may suggest a statin or other cholesterol-lowering medication.
Vitamin C has also been explored as a way to lower CRP levels for people who have an elevated risk of cardiovascular disease.
A suggests that probiotics may also have a positive effect in lowering CRP.
However, more studies have to be done for each method before any definitive claims can be made.
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How Are Normal And Elevated C
C-reactive protein is a marker of inflammation and is typically not detected in the blood unless some degree of inflammation is present in the body.
- CRP measurement is made using a blood sample from a vein. The sample is then taken to a laboratory and analyzed.
- The traditional CRP measurement is often used to detect inflammation in the body. Your health-care provider may order a C-reactive protein level to check for flare-ups of inflammatory diseases such as rheumatoid arthritis, lupus, or vasculitis or to monitor whether anti-inflammatory medications are working to treat a disease or condition.
- Currently, a more highly sensitive measurement to detect CRP is used for cardiovascular risk assessment. This high-sensitive C-reactive protein is termed hs-CRP.
- Because measuring CRP levels at any point in time may be influenced by any infection or inflammation in the body, onetime measurement is generally not regarded as an adequate predictor of cardiovascular risk. Therefore, the U.S. Centers for Disease Control and Prevention recommends checking two separate CRP levels approximately two weeks apart and using the average number of the two readings for cardiovascular risk assessment and screening purposes.
How Much Does The Test Cost
The cost of a hs-CRV test depends on several factors, namely whether you are paying out of pocket or have health insurance. The expense may be covered by insurance, depending on your plan. But there may still be charges related to copays and deductibles.
For specific details on expected costs, talk to your doctor or insurance provider.
At Testing.com, the hs-CRP test is $49.
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When Should I Measure My Hs
Your healthcare professional may recommend this test to check for inflammation due to an infection, to see if you might have an inflammatory disease such as rheumatoid arthritis, or to gauge your risk for a heart attack. If your level is high, they might recommend further tests to assess your risk for heart disease.
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:
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.
Elevated CRP is associated with increased risk of heart disease. While it’s uncertain how much reducing CRP itself can help, elevated levels are a sign that you likely have other risk factors that need to be addressed with aggressive measures.
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What Is The Difference Between Crp And Hs
As youve no doubt guessed, the difference between CRP and hs-CRP is contained in the hs abbreviation high sensitivity.
Traditionally, CRP, or C-reactive protein, is measured down to concentrations of 3 to 5 mg/L hs-CRP is measured down to concentrations of approximately 0.3 mg/L. This improved sensitivity allows hs-CRP to be used to detect low levels of chronic inflammation.
What Is The Most Likely Cause
Chronically elevated CRP levels often signal RA or infectious arthritis, which occurs when a joint becomes infected.
Significantly elevated CRP levels tend to occur with severe infections, such as bacterial or fungal infections. Bacterial infection is responsible for about of the cases involving CRP levels higher than 50 mg/l.
Sometimes, higher levels also occur with certain cancers and other conditions that can cause significant inflammation.
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What Happens After The Test
- You will probably be able to go home right away. It depends on the reason for the test.
- You can go back to your usual activities right away.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to keep a list of the medicines you take. Ask your doctor when you can expect to have your test results.
Hscrp And Cardiovascular Risk: Epidemiologic And Clinical Evidence
Although debate persists regarding the precise physiologic role of CRP, the prognostic value of hsCRP as a marker of cardiovascular risk is now firmly established. hsCRP predicts future cardiovascular risk in a wide variety of clinical populations, including healthy individuals without CVD, patients presenting with acute coronary syndromes, patients with stable angina or in the stable phase after MI, and patients with the metabolic syndrome, diabetes, or renal disease.
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Who May Want To Have High
People with risk factors for cardiovascular disease such as high cholesterol, high blood pressure, prediabetes, diabetes, obesity, and/or a family history of heart disease may most benefit from this screening.
Individuals without other risk factors may also benefit from this screening. Researchers have shown that high hsCRP levels can indicate a risk for a heart attack and stroke, even in individuals who are seemingly healthy.
This screening may help your provider better assess your risk of cardiovascular disease and need for lifestyle modifications, other testing and/or possibly medication.
The hsCRP Screening is most useful when tested with the blood chemistry and hemoglobin A1c screenings to evaluate for cholesterol levels and prediabetes or diabetes.
People who have a known high risk of having a heart attack should consult with a health care provider and consider lifestyle and preventive measures regardless of their hsCRP level.
When Should I Get This Test
Currently, there is no consensus on when to get tested, though some guidelines include recommendations on hs-CRP testing. In a joint committee between the American Heart Association and the CDC, universal hs-CRP screening in adults is not recommended. This test may be most useful in evaluating individuals who have a 10% to 20% chance of having a cardiac event within the next ten years.
It also may be useful for treatment decisions when men and women are older than these respective ages and have LDL-C less than 130 mg/L and meet several other criteria, such as no existing heart disease, diabetes, kidney disease, or inflammatory conditions.
When hs-CRP is evaluated, it has been recommended to have the test repeated to confirm that you have persistent inflammation. The CDC and the American Heart Association recommend that measurement of hs-CRP greater than 10 mg/L be repeated twice, optimally two weeks apart, fasting or non-fasting in patients free of infection or acute illness.
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Hscrp And Atherothrombosis: Biologic Mechanisms
Inflammation characterizes all phases of atherothrombosis and provides a critical pathophysiologic link between early lesion formation and plaque rupture leading to occlusion and infarction., Primary proinflammatory cytokines such as interleukin-l and tumor necrosis factor- potentiate the expression of adhesion molecules on vascular endothelial cells, leading to the recruitment of leucocytes to the arterial wall in the early stages of atheromatous lesion development. Primary cytokines
Sputum Induction And Processing
Sputum induction and processing were performed as described by Pin et al.15, with slight modification 16. Briefly, subjects were premedicated with inhaled salbutamol , and inhaled hypertonic saline solution, administered for 15min from an ultrasonic nebuliser . Subjects were then asked to try to cough sputum into a plastic Petri dish. All adequate plugs of sputum were separated from saliva and treated with 0.1% dithiothreitol followed by Dulbecco’s PBS. After centrifugation, differential cell counts were determined by counting 400 nonsquamous cells in specimens stained using the May-Grünwald-Giemsa method.
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