Remember C-reactive protein is used as an indicator of risk and currently is not itself a target of therapy. The patient must be free of infectious disease optimally for at least a few months and the lowest value of at least 2 hs-CRP tests done a few weeks apart should be utilized. While there are a number of drugs that lower CRP, including statin therapy, there are multiple factors that can raise it, including central adiposity, infectious etiologies or acute plaque rupture. In a patient with significant central adiposity, one will see a small fall in the C-reactive protein level, but you wouldn’t expect to normalize the value unless the patient loses significant amounts of weight. Currently, over 70% of the patients I see are overweight, and weight loss doesn’t come easily to most, so one learns to value small successes.

Once again, I use CRP to help determine level of risk in an intermediate risk population. I’d still say that in the vast majority of cases my decision to treat the patient with lipid lowering therapy doesn’t depend on measuring the serum level of inflammation.

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