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This blood test can predict heart attack risk, and it’s not cholesterol |

Sandy Verma | July 13, 2025 11:24 AM CST

While cholesterol levels are commonly used to assess heart disease risk, research shows that another blood marker—high-sensitivity C-reactive protein (hs-CRP)—may offer even more powerful insight, particularly when it comes to predicting heart attacks caused by silent inflammation.

Heart attack risk and why the hs-CRP test helps predict it early

C-reactive protein (CRP) is a substance produced by the liver in response to inflammation in the body. The high-sensitivity CRP (hs-CRP) test measures very low levels of CRP, helping detect chronic inflammation that may not cause obvious symptoms. Inflammation plays a central role in the development of atherosclerosis—a condition in which arteries become narrowed or blocked due to plaque buildup—raising the risk of heart attacks and strokes.

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According to the American Heart Association (AHA), individuals with elevated hs-CRP levels, even if their cholesterol appears normal, may still face significantly higher cardiovascular risk.

Study confirms: hs-CRP predicts heart attack risk

A major study called the JUPITER trial published in the New England Journal of Medicine in 2008, provided strong evidence that measuring hs-CRP levels can help identify people at risk for heart attacks—even if their cholesterol is normal.In this large-scale study involving over 17,000 participants with normal LDL cholesterol but elevated hs-CRP levels, researchers found that treatment with a statin (rosuvastatin) cut the risk of heart attack by 54% and stroke by 48% compared to placebo. This demonstrated that inflammation—not just cholesterol—plays a critical role in cardiovascular risk.

Interpreting hs-CRP levels and heart attack risk categories

According to guidelines, hs-CRP levels fall into three major risk categories:

<1.0 mg/L – Low cardiovascular risk
1.0–3.0 mg/L – Moderate risk
>3.0 mg/L – High risk

Even in the absence of high LDL cholesterol, values above 3.0 mg/L suggest a greater likelihood of vascular inflammation and arterial damage.

How to lower hs-CRP and reduce heart risk

Several lifestyle and medical interventions can help reduce hs-CRP levels:

Adopt an anti-inflammatory diet (rich in fruits, vegetables, whole grains, and omega-3s)
Exercise regularly (150+ minutes/week of moderate activity)
Quit smoking
Maintain a healthy weight
Consider statin therapy if advised by a physician—particularly if both cholesterol and CRP are high

Statins have been shown not only to lower LDL cholesterol but also to reduce inflammation markers like hs-CRP, as highlighted in the JUPITER trial.Cholesterol is just one piece of the cardiovascular puzzle. Measuring hs-CRP provides insight into hidden inflammation, helping to identify individuals at risk for heart disease—even if their standard lipid panel looks normal. For a more comprehensive cardiovascular assessment, ask your healthcare provider about getting an hs-CRP test alongside traditional cholesterol and Lipoprotein(a) testing