Biomarkers · Inflammation
High-Sensitivity C-Reactive Protein (hs-CRP)
Lower values go with lower risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 30% higher risk of death. We found the same pattern in NHANES
hs-CRP and risk of death
NHANES, our fit with 95% CIPublished curve
Published curve higher than the NHANES fitNHANES fit higher
Risk of death relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.
Risk of death per SD (NHANES)1.30×95% CI 1.26–1.33 · 38,322 adults, 6,162 deaths
Published risk of death1.33×elevated hs-CRP vs reference group (95% CI 1.11–1.61) · Prospective cohort of 4128 community adults enrolled 2009, followed to 2022 for all-cause death
Across studies, risk per SD1.30×NHANES 1.30 [1.26–1.33] · CRELES 1.30 [1.19–1.43]
hs-CRP across cohorts
11.11.25HR per SD (95% CI)
NHANES · United States, 20–8438,322 people · 6,162 deaths1.30 1.26–1.33
CRELES · Costa Rica, 60+2,439 people · 467 deaths1.30 1.19–1.43
CHARLS · China, 50+7,768 people · 1,210 deaths1.30 1.20–1.41
hs-CRP by age and sex
Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.
The percentiles as a table
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 0.34 | 0.71 | 1.57 | 3.93 | 11.2 | 1,430 | NHANES 2017-2018 |
| All | 40-59 | 0.42 | 1.03 | 2.08 | 4.54 | 12.6 | 1,544 | NHANES 2017-2018 |
| All | 60+ | 0.43 | 0.95 | 1.97 | 4.15 | 11.8 | 1,888 | NHANES 2017-2018 |
| All | all | 0.39 | 0.86 | 1.85 | 4.27 | 12.0 | 4,862 | NHANES 2017-2018 |
| Men | 20-39 | 0.33 | 0.66 | 1.38 | 2.94 | 8.22 | 684 | NHANES 2017-2018 |
| Men | 40-59 | 0.48 | 1.04 | 1.81 | 4.04 | 10.3 | 723 | NHANES 2017-2018 |
| Men | 60+ | 0.43 | 0.88 | 1.79 | 4.10 | 11.8 | 956 | NHANES 2017-2018 |
| Men | all | 0.40 | 0.82 | 1.67 | 3.55 | 9.72 | 2,363 | NHANES 2017-2018 |
| Women | 20-39 | 0.34 | 0.74 | 1.90 | 5.18 | 13.4 | 746 | NHANES 2017-2018 |
| Women | 40-59 | 0.39 | 1.01 | 2.61 | 5.61 | 16.0 | 821 | NHANES 2017-2018 |
| Women | 60+ | 0.44 | 0.98 | 2.10 | 4.16 | 11.9 | 932 | NHANES 2017-2018 |
| Women | all | 0.38 | 0.90 | 2.16 | 5.03 | 13.5 | 2,499 | NHANES 2017-2018 |
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
Measured changes in hs-CRP, study by study
8 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| diet | Mediterranean Diet enriched with Extra-Virgin Olive Oil or Tree Nuts | Reduced plasma hs-CRP by >=16% vs baseline at 3 and 5 y with MedDiet + EVOO or nuts (no significant change on low-fat diet) | RCT | Casas R, et al. Long-Term Immunomodulatory Effects of a Mediterranean Diet in… |
| exercise | Aerobic and resistance exercise training | Decreased CRP after exercise training: mean effect size 0.26 (95% CI 0.18 to 0.34) across 83 controlled trials (n=3769) | meta-analysis | Fedewa MV, et al. Br J Sports Med. 2017;51:670-676. |
| nutraceutical | Curcuminoid supplementation (bioavailability-improved preparations) | CRP -6.44 mg/L vs placebo (weighted mean difference); effect seen with bioavailability-improved preparations and duration of 4 weeks or more | meta-analysis | Sahebkar A. Are curcuminoids effective C-reactive protein-lowering agents in… |
| pharmacologic | Statin therapy (Rosuvastatin 20 mg/day) | Rosuvastatin reduced hs-CRP by 37% vs placebo | RCT | Ridker PM, et al. Rosuvastatin to prevent vascular events in men and women with… |
| pharmacologic | Statin therapy for >3 months in adults on maintenance haemodialysis or peritoneal dialysis | Lowers hs-CRP by 3.98 mg/L (95% CI -5.24 to -2.72) vs placebo in dialysis patients | meta-analysis | Sun L, et al. Ren Fail. 2015. Meta-analysis of statin therapy in maintenance… |
| pharmacologic | Ezetimibe 10 mg daily co-administered with atorvastatin (10-80 mg) for 12 weeks in adults with primary hypercholesterolaemia | Adding ezetimibe gives an additional 10% hs-CRP reduction vs atorvastatin alone at 12 weeks (P<0.01) | RCT | Ballantyne CM, et al. Circulation. 2003. Effect of ezetimibe coadministered… |
| supplement | Daily flaxseed supplementation in patients with coronary artery disease (6 RCTs) | Lowers hs-CRP by 1.35 mg/L (95% CI -1.93 to -0.77) in CAD patients | meta-analysis | Sabet HR, et al. Clin Cardiol. 2024. Effects of flaxseed supplementation on… |
| supplement | Vitamin D3 50,000 IU orally every 2 weeks for 12 weeks in women aged 18-40 with endometriosis | Reduces hs-CRP by 0.64 mg/L (95% CI -0.97 to -0.30) vs placebo at 12 weeks | RCT | Mehdizadehkashi A, et al. Gynecol Endocrinol. 2021. The effect of vitamin D… |
Things that worsen it
| Type | Condition or exposure | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Periodontitis | CRP 1.56 mg/L higher in periodontitis patients than controls (weighted mean difference); periodontal therapy lowered CRP by 0.50 mg/L | meta-analysis | Paraskevas S, et al. J Clin Periodontol. 2008;35:277-291. |
| diet | High ultra-processed food consumption | +4.0% hs-CRP per 100 g/day increase in ultra-processed food intake (2.5% independent of BMI) | cross-sectional | Lane MM, et al. Higher Ultra-Processed Food Consumption Is Associated with… |
| sleep | Sleep disturbance and short sleep duration | Shorter sleep duration associated with higher CRP (ES .09; 95% CI .01-.17); sleep disturbance with higher CRP (ES .12; 95% CI .05-.19) | meta-analysis | Irwin MR, et al. Biol Psychiatry. 2016;80:40-52. |
What else moves this marker
They describe those study groups, not an individual, and an association is not a cause.
Diseases and conditions
| What | Effect on the marker | Comparison · population | Source |
|---|---|---|---|
| ↑ Abdominal aortic aneurysm (small/medium, 3.0-5.4 cm) · AAA without clinical CVD vs matched controls | +1.5 mg/L | median hs-CRP 2.8 mg/L (AAA) vs 1.3 mg/L (controls) · 86 AAA patients and 158 age/sex-matched controls, all without history of clinical CVD | case control · PMID 24975961 |
| ↑ Sarcopenia · sarcopenic vs non-sarcopenic participants, serum CRP | SMD +0.51 (95% CI 0.26 to 0.77) | sarcopenia vs no sarcopenia · 17 cross-sectional studies, 3072 with sarcopenia and 8177 without | meta analysis · PMID 28041587 |
Genetic predisposition
| What | Effect on the marker | Comparison · population | Source |
|---|---|---|---|
| ↑ CRP rs3091244 rare T/A alleles (TT, AA, TA genotypes) · SNP group A (TT, AA, TA rare-allele genotypes) vs comparator group in the Greek main cohort (comparator not reported) | +22 mg/L | median CRP 26 mg/L (group A) vs 4 mg/L (comparator) in the Greek main cohort · Greek main cohort of 351 AAA patients (mean aortic diameter 6.25 cm) | case control · PMID 24135623 |
Sources
- Risk curve: Bafei 2023 (PMID 36967048): all-cause HR 1.33 (1.11-1.61) elevated hs-CRP vs reference group. Scaled to US values (NHANES).
- Bafei et al. Sex and age differences in the association between high sensitivity C-reactive protein and all-cause mortality: A 12-year prospective cohort study. Mechanisms of ageing and development. 2023;211:111804.
- Ni et al. Dose-response association between C-reactive protein and risk of all-cause and cause-specific mortality: a systematic review and meta-analysis of cohort studies. Annals of epidemiology. 2020;51:20-27.e11.
- NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.
Map High-Sensitivity C-Reactive Protein (hs-CRP) against another biomarker · Featured: Inflammation (CRP) × albumin.
Related markers: Alpha-1-Antichymotrypsin (AACT) · Alpha-1-Antitrypsin (AAT) · Antinuclear Antibodies (ANA) · CD4:CD8 T-Cell Ratio · CD8+ T-Cell Count · Erythrocyte Sedimentation Rate (ESR) · Fibrinogen · Growth Differentiation Factor-15 (GDF-15)