ivity C-reactive protein (hs-CRP) test may be used to help evaluate an individual for risk of cardiovascular disease (CVD). It may be used in combination with a lipid profile or with other cardiac risk markers, such as a lipoprotein-associated phospholipase A2 (Lp-PLA2) test, to provide added information about heart disease risk. CRP is a protein that increases in the blood with inflammation. Studies have suggested that a persistent low level of inflammation plays a major role in atherosclerosis, the narrowing of blood vessels due to build-up of cholesterol and otherlipids, which is often associated with CVD. The hs-CRP test accurately measures low levels of C-reactive protein to identify low but persistent levels of inflammation and thus helps predict a person's risk of developing CVD. People with higher hs-CRP values have the highest risk of cardiovascular disease and those with lower values have less risk. Specifically, individuals who have hs-CRP results at the high end of the normal range have 1.5 to 4 times the risk of having a heart attack as those with hs-CRP values at the low end of the normal range. The risks of cardiac disease have been as follows: ? Low risk: less than 1.0 mg/L ? Average risk: 1.0 to 3.0 mg/L ? High risk: above 3.0 mg/L These values are only a part of the total evaluation process for cardiovascular diseases. Additional risk factors to be considered are elevated levels of cholesterol, LDL-C, triglycerides, and glucose. In addition, smoking, high blood pressure (hypertension), and diabetes also increase the risk level. Taking nonsteroidal anti-inflammatory drugs (NSAIDs, e.g., aspirin, ibuprofen, and naproxen) or statins may reduce CRP levels in blood. Both anti-inflammatory drugs and statins may help to reduce inflammation, thus reducing CRP. It is important that any person having this test be in a healthy state for the results to be of value in predicting the risk of coronary disease or heart attack. Any recent illness, tissue injury, infection, or other general inflammation will raise the amount of CRP and give a falsely elevated estimate of risk. Women on hormone replacement therapy have been shown to have elevated hs-CRP levels. Since the hs-CRP and CRP tests measure the same protein, people with chronic inflammation, such as those witharthritis, should not have hs-CRP levels measured. Their CRP levels will already be very high due to the arthritis, so results of the hs-CRP test will not be meaningful.