○Targeted Testing

Is CRP Testing Worth It?

Chronic inflammation silently accelerates cardiovascular disease. hs-CRP is a predictive biomarker that identifies people at 2x higher risk—even with normal cholesterol—providing a window for intervention before symptoms appear.

Published 23 January 2026 · 8 min read

higher cardiovascular event risk when hs-CRP exceeds 2 mg/L, even with controlled LDL cholesterol—identifying residual inflammatory risk

Source: [1]

The Short Answer

Yes, for cardiovascular risk stratification. High-sensitivity CRP (hs-CRP) is a predictive biomarker that identifies chronic inflammation—a key driver of atherosclerosis. Research shows hs-CRP above 2 mg/L doubles cardiovascular risk even when LDL cholesterol is controlled. Testing when healthy establishes your baseline inflammatory state, providing actionable data for prevention. The 2025 ACC Scientific Statement supports near-universal screening.^[1][2]

What Is CRP and Why Does It Matter?

C-reactive protein (CRP) is produced by your liver within hours of inflammation occurring anywhere in your body. It's one of the body's acute phase reactants—proteins that spike rapidly when your immune system activates.

There are two versions of the CRP test:

Standard CRP: Measures higher levels (5-200+ mg/L), used for detecting acute infection and monitoring inflammatory conditions
High-sensitivity CRP (hs-CRP): Measures much lower levels (0.1-10 mg/L), designed to detect chronic low-grade inflammation associated with cardiovascular disease

Both measure the same protein—hs-CRP simply uses a more precise assay to capture subtle, chronic inflammatory signals that predict future cardiovascular events.^[3]

Why hs-CRP Is a Game-Changer for Heart Health

Atherosclerosis isn't just about cholesterol—it's fundamentally an inflammatory disease. Cholesterol deposits in arteries trigger an immune response, and chronic inflammation accelerates plaque buildup and increases rupture risk. This is why hs-CRP provides information beyond lipid panels: it directly measures the inflammatory burden driving cardiovascular disease.^[1]

Research from the JUPITER trial demonstrated that people with elevated hs-CRP but normal LDL cholesterol benefited significantly from statin therapy—a finding that reshaped cardiovascular prevention strategies.^[6]

Chronic Inflammation Drives Cardiovascular Disease

Here's what the evidence shows about inflammation and cardiovascular risk:

hs-CRP Predicts Future Events

The 2025 ACC Scientific Statement found hs-CRP is a stronger predictor of recurrent cardiovascular events than LDL cholesterol in statin-treated patients. People with hs-CRP above 2 mg/L have double the cardiovascular risk, even with well-controlled cholesterol.^[1]

Residual Inflammatory Risk Is Real

Even with optimal LDL cholesterol, elevated hs-CRP identifies residual inflammatory risk—a target for newer anti-inflammatory therapies like colchicine and canakinumab. This represents an unmet clinical need that traditional lipid management doesn't address.^[1]

Inflammation Accelerates Plaque Rupture

Chronic inflammation destabilises atherosclerotic plaques, increasing the likelihood they'll rupture and trigger heart attacks or strokes. hs-CRP measures this inflammatory burden, providing a window into plaque stability that cholesterol tests cannot.^[1]

Independent Risk Factor

hs-CRP adds predictive value beyond traditional risk factors (age, blood pressure, smoking, cholesterol, diabetes). For people at intermediate risk, hs-CRP refines risk stratification and helps guide decisions about preventive medication.^[2]

2025 ACC Scientific Statement: Near-Universal Screening Now Warranted

The American College of Cardiology's 2025 Scientific Statement concluded that based on biological advances, consistent epidemiological evidence, and robust clinical trials, near-universal screening for hs-CRP along with targeted inflammation reduction is now warranted in cardiovascular health promotion, primary prevention, and secondary prevention.^[1]

Note: Australian cardiovascular guidelines (RACGP/Heart Foundation 2023) do not yet incorporate hs-CRP into routine risk assessment, focusing instead on traditional risk factors. However, the ACC statement represents the leading edge of evidence-based cardiovascular prevention.^[5]

When hs-CRP Provides Critical Insight

hs-CRP testing is most valuable in these scenarios:

✗ Probably Skip If...

You have an active infection (cold, flu, COVID, UTI)—CRP will be elevated regardless of cardiovascular risk
You've had recent surgery, injury, or dental work (within 2-4 weeks)
You're experiencing an autoimmune flare or acute illness
You're clearly high-risk (multiple cardiovascular risk factors) and already on optimal preventive therapy
You're clearly low-risk (young, no risk factors, excellent health markers) with no family history

✓ Worth Considering If...

You're at intermediate cardiovascular risk and seeking additional data to guide prevention strategies
You have a family history of early heart disease but your lipid panel is normal
You want to establish a baseline inflammatory state while healthy—before symptoms appear
You've had a cardiovascular event and want to assess residual inflammatory risk despite controlled LDL
You're considering preventive medication and want comprehensive risk assessment beyond cholesterol

Testing When Healthy Provides Your Baseline

The power of hs-CRP testing lies in establishing your baseline inflammatory state before symptoms appear. This is proactive health assessment—not reactive symptom investigation.

When you test while healthy, you gain:

Early identification: Years or decades before cardiovascular events
Intervention window: Time to address inflammation through lifestyle or medication
Tracking capability: Ability to measure whether your prevention strategies are working

Waiting until symptoms appear means you've missed the opportunity for early intervention.

The Specificity Limitation You Need to Understand

Here's the critical limitation of CRP testing: it's completely non-specific. An elevated CRP tells you there's inflammation somewhere in your body, but not where or why.

CRP can be elevated by many causes:

Risk Factor	Why It Matters
Acute infections	Bacterial or viral infections (can spike CRP to 100+ mg/L), recent illness
Recent injury or surgery	Tissue damage, surgical trauma, dental procedures elevate CRP for 2-4 weeks
Autoimmune conditions	Rheumatoid arthritis, lupus, inflammatory bowel disease cause chronic elevation
Obesity	Adipose tissue produces inflammatory cytokines—weight contributes to baseline CRP
Lifestyle factors	Smoking, poor sleep, chronic stress, sedentary behaviour increase inflammation
Chronic conditions	Periodontal disease, chronic kidney disease, some cancers elevate CRP

CRP Alone Cannot Diagnose Anything

A CRP test cannot tell you where the inflammation is or what's causing it. An elevated result indicates that investigation may be warranted—your health practitioner will interpret CRP alongside your symptoms, medical history, and other test results to determine the likely cause.

For cardiovascular risk assessment, this means ruling out other causes of elevation before attributing high hs-CRP to atherosclerotic inflammation.^[4]

Why Timing Determines Accuracy

For cardiovascular risk assessment, timing is everything. Testing at the wrong time will give misleading results that don't reflect your baseline inflammatory state.

You Must Be Well When Tested

For cardiovascular risk assessment, you must be well when tested. Even a mild cold can spike CRP for 2-4 weeks, invalidating results for cardiovascular purposes.

For reliable hs-CRP measurement:

Wait at least 2 weeks after any illness or infection resolves
Avoid testing within 2-4 weeks of surgery, injury, or dental work
Two measurements, 2 weeks apart, provide more reliable risk assessment than a single test
If your initial result is above 10 mg/L, your health practitioner will recommend retesting after ruling out acute inflammation^[4]

What Your Results Mean

For cardiovascular risk assessment, hs-CRP results are interpreted using established thresholds from the American Heart Association:

< 1 mg/LLower cardiovascular risk

1-2 mg/LAverage cardiovascular risk

2-3 mg/LHigher cardiovascular risk—consider intervention

> 3 mg/LSignificantly elevated risk—warrants investigation and action

> 10 mg/LLikely acute inflammation—retest after ruling out infection/injury

What hs-CRP Tells You

What hs-CRP Cannot Tell You

What to Do with Elevated hs-CRP

If your hs-CRP is elevated (above 2 mg/L), here's what the evidence supports:

Rule Out Other Causes First

Your health practitioner will investigate for recent infection, inflammatory conditions, obesity, or other causes of elevation. This may involve retesting in 2-4 weeks, checking for autoimmune markers, or evaluating for chronic conditions.

Lifestyle Modifications Reduce Inflammation

Mediterranean-style diet, regular exercise, weight management, smoking cessation, and adequate sleep all significantly reduce chronic inflammation. Research shows these interventions lower hs-CRP levels—and they're often the first-line approach.^[4]

Consider Preventive Medication

For people at intermediate or high cardiovascular risk with elevated hs-CRP, statins reduce both cholesterol and inflammation. Newer anti-inflammatory therapies (low-dose colchicine, canakinumab) target residual inflammatory risk in selected patients.^[1]

Track Over Time

Serial hs-CRP measurements allow you to assess whether your prevention strategies are working. Falling hs-CRP levels provide objective evidence that lifestyle changes or medication are reducing inflammatory burden.

Your Health Practitioner Will Consider the Complete Picture

hs-CRP is one data point in comprehensive cardiovascular risk assessment. Your health practitioner will interpret it alongside:

Your lipid profile (total cholesterol, LDL, HDL, triglycerides, ApoB if available)
Blood pressure and blood glucose/HbA1c
Family history of cardiovascular disease
Smoking status and other lifestyle factors
Age, sex, and ethnicity
Whether you're already on preventive medication

An elevated hs-CRP in someone with otherwise low cardiovascular risk may warrant different action than the same result in someone with multiple risk factors. This is context-dependent risk stratification—the hallmark of personalised preventive medicine.

The Cost vs. Knowing

hs-CRP testing typically costs $30-50 when ordered through direct-to-consumer pathology services. Medicare covers CRP testing when ordered by a health practitioner with clinical indication, though routine cardiovascular screening with hs-CRP in healthy people may not always meet Medicare criteria (Australian guidelines don't yet strongly recommend it).

Here's how to think about the cost:

The Cost of Testing

The Cost of Not Knowing

hs-CRP Adds Most Value in the 'Grey Zone'

If you're clearly high-risk (multiple cardiovascular risk factors, established disease) or clearly low-risk (young, no risk factors, excellent health markers), hs-CRP is less likely to change your management.

The test adds most value when you're at intermediate risk—this is where additional data tips the scales toward earlier or more aggressive intervention. For people in this grey zone, the $30-50 cost is trivial compared to the value of refined risk stratification.

The Bottom Line

hs-CRP is a predictive biomarker that identifies chronic inflammation driving cardiovascular disease.

Research shows hs-CRP above 2 mg/L doubles cardiovascular risk even with controlled LDL cholesterol—identifying residual inflammatory risk that traditional lipid panels miss. The 2025 ACC Scientific Statement supports near-universal screening based on robust clinical trial evidence.

Key insights:

Predictive power: hs-CRP identifies people at 2x higher cardiovascular risk before symptoms appear
Actionable: Elevated hs-CRP guides decisions about lifestyle intervention and preventive medication
Timing-dependent: Testing when healthy provides your baseline—testing during illness invalidates results
Non-specific: Elevated CRP requires clinical interpretation to rule out other causes of inflammation
Context-dependent: Adds most value for people at intermediate cardiovascular risk

The $30-50 cost is trivial compared to the value of knowing whether chronic inflammation is silently accelerating your cardiovascular risk. Discuss hs-CRP testing with your health practitioner if you're seeking comprehensive cardiovascular risk assessment beyond traditional lipid panels.

Frequently Asked Questions

They measure the same protein (C-reactive protein) but at different scales. Standard CRP detects higher levels (5-200+ mg/L) and is used for infection and inflammatory conditions. High-sensitivity CRP (hs-CRP) measures much lower levels (0.1-10 mg/L) and is designed for cardiovascular risk assessment in apparently healthy people. The hs-CRP assay is simply more precise at detecting subtle, chronic low-grade inflammation that predicts cardiovascular events.

CRP rises rapidly in response to any inflammation—a cold, injury, or infection can spike CRP for 2-4 weeks. For cardiovascular risk assessment, you need to capture your baseline inflammatory state, not a temporary elevation from acute illness. Testing when unwell will give a falsely elevated result that doesn't reflect your true cardiovascular risk.

Many things. Infections (bacterial and viral), autoimmune conditions (rheumatoid arthritis, lupus, IBD), recent surgery or injury, obesity, smoking, chronic stress, poor sleep, periodontal disease, some cancers, and chronic kidney disease can all elevate CRP. This is why CRP is non-specific—it indicates inflammation somewhere, but doesn't tell you where or why. Your health practitioner will interpret results in clinical context.

Yes. Lifestyle modifications significantly reduce chronic inflammation. Evidence supports Mediterranean-style diet (olive oil, vegetables, fruits, legumes, nuts, fish), regular exercise, weight management, smoking cessation, and adequate sleep. Statins also lower CRP independently of their cholesterol-lowering effect. For people at intermediate cardiovascular risk with elevated hs-CRP, lifestyle changes are often the first-line approach before considering medication.

CRP testing (including hs-CRP) is generally covered by Medicare when ordered by a health practitioner with clinical indication. However, routine cardiovascular screening with hs-CRP in healthy people may not always meet Medicare criteria, as Australian cardiovascular guidelines don't strongly recommend it for primary prevention (unlike the 2025 ACC Scientific Statement). Your GP can advise on rebate eligibility for your specific situation.

For cardiovascular risk assessment, two measurements taken about 2 weeks apart provide more reliable results than a single test. CRP can vary day-to-day, so averaging two readings gives a more stable estimate of your baseline inflammatory status. If your initial result is above 10 mg/L, you should definitely retest after ruling out acute causes of inflammation.

No. Elevated hs-CRP indicates increased inflammation, which is associated with higher cardiovascular risk, but it does not diagnose heart disease. Many people with elevated hs-CRP never develop cardiovascular problems, and some people with normal hs-CRP do. It's one risk factor among many—your health practitioner will interpret it alongside your complete risk profile. hs-CRP is predictive, not diagnostic.

Research shows hs-CRP above 2 mg/L doubles cardiovascular event risk even when LDL cholesterol is well-controlled. This threshold identifies residual inflammatory risk that traditional lipid management doesn't address. For people at intermediate cardiovascular risk, crossing the 2 mg/L threshold may tip the scales toward earlier or more aggressive preventive intervention (lifestyle modifications or medication). It's the key threshold that separates average from elevated cardiovascular risk.

Disclaimer:This information is educational only and not medical advice. Results should be interpreted by your health practitioner in the context of your symptoms and health history. Treatment decisions should be made with your doctor or specialist.