C-reactive Protein

Strong CVD Predictor

Elevated C-reactive Protein (CRP) levels have been recognized as a predictor of heart disease.^71-73 CRP is a strong independent risk factor for CVD,^72,74, perhaps even stronger than LDL cholesterol level.⁷³ Women with no history of heart disease who were in the highest quartile of CRP levels were more than 5 times more likely to experience a cardiac event than those in the lowest quartile.^72,74

Table 4 shows risk stratification using CRP levels.

Table 4. CRP Levels and Associated Cardiovascular Risk

CRP Level, mg/L	Risk Level
<1	Low
1-3	Intermediate
≥3	High

CRP Differences by Race and Gender

Significant differences in elevated CRP levels have been associated with race and sex (Figure 9).⁷¹

Figure 9. Median CRP Levels by Race and Sex⁷¹

African American women, who are at higher risk for heart disease than other populations, have the highest prevalence of elevated CRP levels (58%).⁷¹

Hormone replacement therapy (HRT) has been shown to raise CRP levels.⁷⁵ In a large study of postmenopausal women, CRP levels were significantly higher in HRT users compared with nonusers.⁷⁵