Heart Health

hs-CRP not measured

hs-CRP ≥2 mg/L, confirmed on a repeat test? (further testing beyond basic labs) Not measured

Testhscrp-unknownNo one has reached this rule yet

Order hs-CRP — a low-cost blood test that can independently support the decision

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.

  • A test worth considering

    hs-CRP (high-sensitivity C-reactive protein) is a low-cost blood test that can independently support the statin decision if you're unsure.

    Confirmed on a repeat test with no identifiable cause, an hs-CRP ≥2 mg/L supports high-intensity statin therapy at borderline risk — capturing inflammatory risk a standard lipid panel misses.

    2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Test — not yet ordered

  • Reasonable — worth discussing

    Your Lp(a) (78 mg/dL) is elevated. It argues for initiating or intensifying LDL-lowering, on top of whatever your risk category already indicates.

    A point of precision worth having: elevated Lp(a) is a reason to lower LDL harder, not a reason to adopt a different numeric target. The guideline uses it to favour starting or intensifying treatment; your actual LDL goal still comes from your risk category, which is stated separately above. There is no approved drug that lowers Lp(a) itself, and the first outcomes trial of one was negative in September 2026 — so LDL, blood pressure, glucose, and smoking are where the leverage is. First-degree relatives may want their own Lp(a) checked once, since it is inherited.

    2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class 2a/2b

An example person who reaches it

“Borderline risk + high Lp(a)” — an illustrative profile, not a real user.

58-year-old manBP 132/82LDL 140Lp(a) 78 mg/dL10-yr PREVENT-ASCVD 4.9%

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)One or more present
  4. Coronary artery calcium (CAC) score? (further testing beyond basic labs)Not measured
  5. hs-CRP ≥2 mg/L, confirmed on a repeat test? (further testing beyond basic labs)Not measured ← this rule

Where it sits

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

Sources

Cited by the recommendations above.

What we are least sure of here

  • Q19Should test verdicts be framed as 'what decision would this change?' rather than 'worth doing'?

Review this rule

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Runs in lib/engine/lipidPathway.ts as hscrp-unknown.