Association Between Chronic Inflammation and Cardiovascular Disease ― Focus on High-Sensitivity C-Reactive Protein ―

BACKGROUND: Despite intensive control of established coronary risk factors, such as dyslipidemia, hypertension, and diabetes, cardiovascular events continue to occur in high-risk patients. Residual risk attributable to chronic low-grade inflammation has therefore emerged as a major clinical concern. METHODS AND RESULTS: This narrative review summarizes current evidence regarding the role of low-intensity chronic inflammation in cardiovascular disease risk, based on literature searches of PubMed. Randomized controlled trials targeting inflammation, including Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS), Colchicine Cardiovascular Outcomes Trial (COLCOT), and Low-Dose Colchicine 2 Trial (LoDoCo2), demonstrated that suppression of chronic inflammation reduces cardiovascular disease events independently of low-density lipoprotein cholesterol levels. In addition, evidence from randomized trials, observational studies, and systematic reviews supports the clinical value of high-sensitivity C-reactive protein for identifying residual inflammatory risk, including in Japanese patients at high cardiovascular risk. CONCLUSIONS: High-sensitivity C-reactive protein is a practical and reliable biomarker for assessing low-grade chronic inflammation. Therapeutic strategies targeting inflammation are as important as lipid-lowering interventions and represent a promising approach for reducing residual cardiovascular risk.