Q. I have some inquiries regarding my mother's health-screen report. It indicates that the result for hs C-reactive protein is 23mg a litre which exceeds the minimum value of 4.7mg a litre. Studies say that this shows risk of heart attack and stroke and the higher the value, the higher the risk.

My concern is whether she should go directly for a check-up at a specialist centre or just the eighbourhood clinic?

A. The hsCRP is short for high sensitivity C-reactive protein. It is an inflammatory marker present in the blood. Studies have shown that high levels of hsCRP may be associated with higher risk of heart attacks and strokes.

However being an inflammatory marker, hsCRP can also be higher in patients with an acute illness such as recent sore throat, fever or inflammatory diseases like arthritis.

Markedly elevated hsCRP levels such as 23 mg a litre are more likely to be due to inflammatory processes. It will have to be repeated again for a separate analysis.

If it is persistently elevated, the doctor may look for possible inflammatory diseases and also assess the cardiovascular risk profile of the patient.

Cardiovascular risks refer to risk factors that predispose a person to heart diseases and stroke. They include history of smoking, sedentary lifestyle, family history of heart attacks, history of low good cholesterol (HDL cholesterol), history of high bad cholesterol (LDL cholesterol), history of diabetes, history of hypertension and old age.

If the patient has no infection or inflammation but has more than two cardiovascular risk factors, two elevated hsCRP readings will suggest that he or she has a higher cardiovascular risk than that estimated by using the usual risk assessment.

Further cardiovascular assessment for such patients with a treadmill electrocardiogram may be useful.

In the absence of multiple cardiovascular risks, inflammatory processes and infections, a mildly elevated hsCRP will only require one to pay more attention to healthy living. These include regular exercise, healthy eating habits, quitting smoking and maintaining a healthy body weight.

Actually, at the moment, provided there are no other risk factors such as high cholesterol, high blood pressure or diabetes, all she needs to do is to repeat another blood test when she is healthy and with no evidence of infection or any inflammation.

But if risk factors are present, you should consider a review with a cardiologist.

DR CHNG SHIH KIAT, SENIOR FAMILY PHYSICIAN, RAFFLES HEALTHSCREENERS.

For information on health screening at Raffles Hospital, please call 6311-1222 or send an e-mail to healthscreener@raffleshospital.com