Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct 1:zwaf609.
doi: 10.1093/eurjpc/zwaf609. Online ahead of print.

Factors Associated with Elevated High-Sensitivity C-Reactive Protein Levels in Individuals with Atherosclerotic Cardiovascular Disease in the US and the UK

Kausik K Ray  1 , Simon Bertram Reuter  2 , Aysegul Dalbeler  2 , Mads D Faurby  2 , Gasper Letnar  3 , Jimmi Mathisen  2 , Michael G Nanna  4 , Fu Siong Ng  5 , Jonathan Pearson-Stuttard  6   7 , Naveed Sattar  8 , Andrew Thompson  6   9 , Ann Marie Navar  10
Affiliations

Factors Associated with Elevated High-Sensitivity C-Reactive Protein Levels in Individuals with Atherosclerotic Cardiovascular Disease in the US and the UK

Kausik K Ray et al. Eur J Prev Cardiol. .

Abstract

Aim: Novel therapies are under evaluation for upstream inhibition of inflammatory pathways in atherosclerotic cardiovascular disease (ASCVD). Elevated high-sensitivity C-reactive protein (hsCRP) is a downstream marker of these pathways but is not routinely measured. We aimed to identify potential factors associated with elevated hsCRP.

Methods: This cross-sectional study included individuals with ASCVD from the UK Biobank (2006-2010) and the US National Health and Nutrition Examination Survey (NHANES; 1999-2010 and 2015-2018). Factors associated with elevated hsCRP (2-10 mg/L) were evaluated using multivariable logistic regression.

Results: Six factors were associated with greater odds of elevated hsCRP in both cohorts (UK Biobank n = 23,045; NHANES n = 3,415): obesity (UK Biobank odds ratio [OR] [95% confidence interval (CI)]: 3.48 [3.18-3.80]); NHANES 4.11 [2.66-6.34]), overweight (1.56 [1.44-1.70]; 2.26 [1.51-3.38]), being a current smoker (2.47 [2.27-2.69]; 1.96 [1.23-3.10]), female sex (1.69 [1.59-1.80]; 1.69 [1.24-2.31]), and increased low-density lipoprotein cholesterol (1.05 [1.04-1.06]; 1.00 [1.00-1.00], per 10 mg/dL increase) and triglyceride levels (1.01 [1.01-1.01]; 1.00 [1.00-1.00], per 10 mg/dL increase) (all p <0.05). Receiving statins was associated with lower odds in both cohorts (UK Biobank OR [95% CI] 0.69 [0.64-0.75]; NHANES 0.54 [0.39-0.74]). When these factors, plus chronic kidney disease stage G3-5, were considered in combination, hsCRP levels were higher in individuals with more factors (median hsCRP with seven factors: UK Biobank 5.39 mg/L; NHANES 6.99 mg/L).

Conclusions: The factors identified may support data-driven targeted testing to identify those most likely to have elevated hsCRP, who could potentially benefit from emerging anti-inflammatory therapies.

Keywords: ASCVD; NHANES; UK Biobank; hsCRP; real-world evidence; systemic inflammation.

Plain language summary

New treatments called anti-inflammatories are being developed to treat heart disease caused by a build-up of plaque in the blood vessels, known as atherosclerotic cardiovascular disease (ASCVD). A blood test to look for higher levels of a biomarker called C-reactive protein (CRP) might help doctors find out who could benefit from these treatments, so to find out more about these patients, we measured CRP levels in people with ASCVD in the UK and the USA and looked at which groups tended to have higher CRP levels. People with the following characteristics were more likely to have higher CRP levels: those with overweight or obesity, current smokers, women, those not receiving statins (a type of medication used to treat high cholesterol), and those with higher levels of low-density lipoprotein cholesterol (often called ‘bad cholesterol’) and triglycerides (a type of fat) circulating in the blood.These findings may help doctors to decide who to test for higher CRP levels, to help to identify patients who might benefit from new treatments that reduce inflammation.

PubMed Disclaimer