This simple test can help spot silent inflammation linked to heart disease

Business Standard

3 days ago

You might feel perfectly healthy, yet your body could be quietly fighting inflammation - a hidden trigger for heart disease, cancer, Alzheimer's and more. The high-sensitivity C-reactive protein (hs-CRP) test is a simple blood test that can uncover this silent risk long before symptoms start, giving you the chance to take preventive action.
What is the hs-CRP test?
The high-sensitivity C-reactive protein test measures a protein in the blood that rises when there is inflammation in the body. Unlike the standard cholesterol test, which only measures fat levels, hs-CRP detects vascular inflammation, a key factor in many serious illnesses.
"The high-sensitivity C-reactive protein (hs-CRP) test is a more sensitive version of the standard CRP test. While the standard test can detect moderate to severe inflammation (10–1000 mg/L), it can miss minor changes. hs-CRP can detect as low as 0.1 mg/L and can be used to detect low-grade, chronic inflammation. This enhanced sensitivity helps detect vascular inflammation well before clinical symptoms appear," said Dr Rohit Deshpande, MBBS, MD (Medicine), Lilavati Hospital Mumbai.
How it works
hs-CRP can detect inflammation in the range of 0.1 mg/L to about 10 mg/L, making it possible to spot subtle inflammation in individuals who appear otherwise healthy.
" Cholesterol and lipid levels measure one aspect of heart risk but do not consider inflammatory injury to blood vessels. hs-CRP provides a second dimension to risk measurement by identifying silent inflammation that may destabilise arterial plaques and induce clotting. Combined with lipid testing, it offers a more complete risk profile," Dr Deshpande added.
Why inflammation matters beyond the heart
While the test is often associated with heart disease risk, inflammation is a root cause in many other illnesses. Elevated hs-CRP can be an early signal that the body is fighting a hidden health issue, even when there are no symptoms.
Dr Sabyasachi Pal, cardiologist with BM Birla Heart Hospital, told Business Standard, "hs-CRP is a non-specific inflammation marker. A raised value tells you there is inflammation somewhere, but not which organ. It can go up with common problems such as dental infections, eye infections, skin infections, and essentially any inflammatory process in the body. It's a signal to look for a cause; it doesn't localise the cause."
Dr Deshpande further explained that though hs-CRP is well accepted for cardiovascular risk determination, chronic elevation may signal:
Autoimmune and chronic inflammatory conditions, rheumatoid arthritis, lupus, vasculitis, and polymyalgia rheumatica.
Metabolic states, type 2 diabetes, metabolic syndrome, and insulin resistance, even when glucose and cholesterol levels are close to normal.
Obesity associated inflammation, especially in those with visceral fat excess, where adipose tissue releases inflammatory mediators.
Chronic kidney disease usually with persistent vascular inflammation and oxidative stress.
Some cancers for example, colorectal, lung, and ovarian cancers, where inflammation is integral to the disease process.
Chronic infections for example, chronic sinusitis, periodontal disease, or latent tuberculosis.
Respiratory diseases for example, COPD (Chronic Obstructive Pulmonary Disease) and asthma, particularly during exacerbations.
Inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, where levels are associated with disease activity.
"Most recently, hs-CRP has also been studied for its potential to identify people at risk of neurodegenerative diseases like Alzheimer's, which may be linked to inflammation that contributes to disease progression," added Dr Javed Ali Khan, Senior Consultant MD, DM Cardiology, Ramakrishna CARE Hospitals.
Understanding your hs-CRP numbers
Low risk: below 1.0 mg/L – little vascular inflammation.
Moderate risk: 1.0–3.0 mg/L – deserves lifestyle assessment and preventive action.
High risk: more than 3.0 mg/L – reflects large degree of inflammation and increased chance of vascular events.
Levels greater than 10 mg/L are typically caused by acute infection or other ongoing inflammatory processes and should be evaluated separately prior to interpreting cardiovascular risk, shared Dr Deshpande.
Dr Khan cautioned, "Please keep in mind that temporary increases can occur as a result of infection, injuries, or surgery. In such cases, it is advisable to repeat the test after 2-3 weeks before making any long-term conclusions."
What happens if your hs-crp is high?
"A raised hs-CRP with otherwise normal lipids can prompt physicians to look for occult causes of inflammation- anything from gum disease to incipient autoimmune diseases. In cardiovascular risk assessment, further testing like coronary calcium scoring, measurement of carotid intima-media thickness, or stress testing can be recommended. Preventive treatments such as statins or anti-inflammatory treatment may be given even if cholesterol is normal in some instances," said Dr Deshpande.
Adding to the point, Dr Khan said, "Other cardiovascular tests may be advised, including a lipid profile, fasting glucose, blood pressure check, ECG, or coronary calcium score. Even in the absence of overt disease, the persistent elevation of hs-CRP may prompt anticipatory prevention and lifestyle therapy aimed at minimizing long-term health risk."
Cost and availability in india
The hs-CRP test is widely available, does not require fasting, and typically costs between ₹450 and ₹800 in most cities, though prices in metro areas may reach ₹1,500. It is often included in annual health check-up packages.
Lowering your hs-crp naturally
Experts say that lowering hs-CRP frequently coincides with better overall health.
Exercise on a regular basis
Healthy weight
No smoking or alcohol
Anti-inflammatory diet full of vegetables, fruits, whole grains
Omega-3 fatty acids are also beneficial
"For those with underlying medical illness, control of blood sugar, blood pressure, and cholesterol is important. In some high-risk individuals, physicians may prescribe statins or specific anti-inflammatory drugs, which have been found to decrease hs-CRP and lower cardiovascular event rates," said Dr Deshpande.