Inflammation and Heart Risk: Should You Get Your CRP Checked?

Updated July 2026

Most people track their cholesterol. Far fewer have ever heard of the blood test that can flag heart risk even when cholesterol looks perfect. That test measures inflammation, and it identifies danger that an LDL number alone can miss.

What is hs-CRP, and what does it tell you?

It's a blood test for inflammation in your blood vessels. High-sensitivity C-reactive protein, or hs-CRP, rises when there's active, unstable plaque in your arteries, the kind most likely to rupture and trigger a heart attack or stroke. A normal level is below 2 mg/L; persistently above that signals elevated risk. The reason it's such a useful complement to cholesterol testing is that it detects a different piece of the disease: not how much cholesterol is circulating, but how inflamed and unstable the existing plaque is.

Can inflammation raise your risk even if your cholesterol is at goal?

Yes, and this is the finding that should change how we think about risk. A study of more than 3,000 patients with known heart disease tracked their outcomes by hs-CRP level. What made it striking is that every one of them already had their LDL cholesterol below 70 mg/dL, meaning they were all "at goal" and on statins. Even so, those with elevated hs-CRP had double the risk of a subsequent cardiac event, a heart attack, stroke, death, stent, or bypass, compared with those whose inflammation was low. In other words, you can do everything right on cholesterol and still carry meaningful hidden risk if inflammation is high. That's the missed opportunity a CRP test can catch.

What raises your CRP in the first place?

Mostly the same things that damage your arteries: smoking, chronic stress, and diet. The most pro-inflammatory foods are exactly the ones filling most grocery carts: processed meats like ham and bacon, sugary drinks, trans fats, refined grains like white bread and white pasta, processed snacks like chips and crackers, and desserts like cookies, candy, and ice cream. Excess alcohol is pro-inflammatory too. The flip side is that a whole-food, plant-based pattern is one of the most powerful anti-inflammatory tools available, and unlike a drug, it has no side effects.

One caveat around CRP testing. An hs-CRP elevation will tell you that your inflammatory load is higher than ideal – it doesn't tell you where the inflammation is coming from. All sorts of things can lead to inflammation – a tendon injury, a gastric erosion, a bug bite. So one hs-CRP elevation may not be enough to determine that something is going on with your arteries. It's more the persistence of the elevation that matters.

Is there a medication that lowers inflammation to prevent heart attacks?

Now there is, and it's a genuine milestone. For years, the response to studies like the one above was to call for new anti-inflammatory drugs, and one has now arrived. In 2023, the FDA approved a low-dose form of colchicine, an old anti-inflammatory drug long used for gout, sold under the brand name Lodoco, as the first anti-inflammatory drug specifically approved to reduce cardiovascular risk.

The approval rested largely on the LoDoCo2 trial, which gave more than 5,000 patients with chronic coronary disease either 0.5 mg of colchicine daily or a placebo on top of their usual statin and aspirin. Major cardiovascular events dropped meaningfully, from about 9.6% on placebo to 6.8% on colchicine, and the drug measurably lowered CRP. It's worth knowing the dose is deliberately specific: this is a 0.5 mg preparation designed for long-term daily use, not the higher doses used to treat a gout flare. It isn't for everyone, and it's contraindicated in people with kidney failure or severe liver disease, so it's a conversation to have with your physician.

But notice what colchicine is doing. It dampens the inflammatory response to plaque; it doesn't remove the plaque or address why it formed. That makes it a valuable tool for people who already have significant disease, not a substitute for the fundamentals. We reach for drugs awfully quickly, often before we've come close to exhausting the lifestyle changes that address the actual cause.

What should you take away?

That there's more to heart risk than a cholesterol number, and much of it is under your control. If you have heart disease or risk factors, ask your doctor whether an hs-CRP test makes sense for you; it can reveal risk your cholesterol number hides. Then act on what drives inflammation in the first place: eat whole, plant-based food, don't smoke, move, and manage stress. For at least two food choices a day, Step One Foods is built to help, working on cholesterol and inflammation together. For the bigger picture on how these pieces fit, see what inflammation is and how it affects your heart.

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