Heart Health

hs-CRP 2 or above, confirmed

hs-CRP ≥2 mg/L, confirmed on a repeat test? (further testing beyond basic labs) Yes

Recommendationhscrp-elevatedNo one has reached this rule yet

Supports starting a high-intensity statin, independent of the CAC result

Clinical review

All reviewers

No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.

What someone who reaches this rule is told

Word for word, as generated for the example person below. Figures in the text are theirs.

  • Reasonable to do

    Your elevated hs-CRP supports starting a high-intensity statin, independent of your CAC result.

    Expert guidelinesOfficial guidelines recommend it, based on trials plus expert judgment.

    ACC/AHAClass 2aLevel B-R
    Why, and the source

    Your hs-CRP (3.2 mg/L) is at or above 2 mg/L. The guideline notes that hs-CRP ≥2 mg/L, confirmed on a repeat test with no identifiable cause, supports high-intensity statin therapy at borderline risk.

    Where the guidelines stand

    ACC/AHA (US)

    • RecommendsClass 2aLevel B-R

      Graded for borderline risk, with hs-CRP of 2 mg/L or higher on two successive occasions and no identifiable cause. JUPITER is the main trial behind it.

      2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Recommendation behind this rule · class and level read from the guideline tables on 2026-09-30

    2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class 2a · Level B-R

  • Needs confirming before it counts

    hs-CRP 3.2 mg/L is on your record, but one reading isn't enough to act on.

    Expert guidelinesOfficial guidelines recommend it, based on trials plus expert judgment.

    ACC/AHAClass 2aLevel B-R
    Why, and the source

    A single hs-CRP at or above 2 mg/L is not enough to act on. The guideline asks for two successive measurements with no identifiable cause before using it to support high-intensity statin therapy, because it rises with any inflammation at all — a cold, a sprain, a flare of arthritis. Until it is confirmed it is listed here but does not tip the decision. A repeat hs-CRP, at least two weeks apart, with no infection, injury, or flare of an inflammatory condition in between.

    Where the guidelines stand

    ACC/AHA (US)

    2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class 2a · Level B-R

An example person who reaches it

“Borderline risk, calcium found, hs-CRP raised” — an illustrative profile, not a real user.

57-year-old manBP 128/80LDL 138calcium score 140hs-CRP 3.210-yr PREVENT-ASCVD 4.0%

Their path through cholesterol

  1. Known ASCVD (prior heart attack, stroke, or revascularization)?No
  2. Your situation (severe hypercholesterolemia short-circuits the risk score)10-yr risk 3–5% (borderline)
  3. A risk-enhancing factor that counts? (weighted — a single unconfirmed hs-CRP does not count until repeated)None on record
  4. Coronary artery calcium (CAC) score? (further testing beyond basic labs)Above 0
  5. hs-CRP ≥2 mg/L, confirmed on a repeat test? (further testing beyond basic labs)Yes ← this rule

Where it sits

Asked after: 10-year risk 3% to under 5%

Sources

Cited by the recommendations above.

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