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The relationship of baseline high-sensitivity C-reactive protein with incident cardiovascular events and all-cause

Adam Hartley1, Somayeh Rostamian1, Amit Kaura1

  • 1National Heart and Lung Institute, Imperial College London, UK.

Ebiomedicine
|June 5, 2025
PubMed

Insights

High-sensitivity C-reactive protein (hsCRP) can predict long-term cardiovascular events and mortality in hypertensive patients. Elevated hsCRP levels independently indicate increased risk for major cardiac events and death.

Area of Science:

  • Cardiology
  • Biomarkers
  • Preventative Medicine

Background:

  • Cardiovascular event prediction is crucial for optimizing preventative therapies.
  • The role of high-sensitivity C-reactive Protein (hsCRP) in risk stratification requires further investigation.
  • Hypertension is a significant risk factor for cardiovascular disease.

Purpose of the Study:

  • To evaluate the utility of baseline serum hsCRP for predicting very long-term cardiovascular events.
  • To assess hsCRP as an independent predictor in patients with hypertension.
  • To analyze data from the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy Study.

Main Methods:

  • Post-hoc analysis of a randomized controlled trial (ASCOT Legacy Study).
  • Measurement of serum hsCRP using ELISA, analyzed in tertiles and continuously.
  • Outcomes adjusted for cardiovascular risk factors and treatment allocation, with up to 20 years of follow-up.

Main Results:

  • The highest tertile of hsCRP was associated with increased risk of non-fatal myocardial infarction, fatal coronary heart disease, total coronary events, and all-cause mortality.
  • Higher hsCRP levels significantly improved the prediction of non-fatal MI and fatal CHD (Net Reclassification Index 9.68%, p < 0.0001).
  • Insufficient evidence was found for an association between hsCRP and stroke events.

Conclusions:

  • Baseline serum hsCRP is an independent predictor of long-term cardiovascular events and all-cause mortality in stable hypertensive patients.
  • hsCRP adds significant value to existing risk factors for predicting major adverse cardiovascular outcomes.
  • These findings support the use of hsCRP in risk assessment for hypertensive individuals.
Abstract

Keywords:
C-reactive proteinCardiovascular eventsInflammationMortality

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