hs-CRP vs ESR — which inflammation marker should I track?
For cardiovascular and metabolic context, hs-CRP is the more informative and reproducible marker. ESR is older, less specific, and more useful for tracking certain rheumatologic and infectious conditions over time. They answer different clinical questions.
Full answer
hs-CRP and ESR both reflect inflammation, but they measure different things and answer different questions. hs-CRP (high-sensitivity C-reactive protein) directly measures a single liver-produced acute-phase protein, responds quickly (within hours to days), and is the standard marker for the low-grade systemic inflammation that matters in cardiovascular and metabolic risk stratification. ESR (erythrocyte sedimentation rate) is older and indirect — it measures how fast red cells settle in a tube, which depends on fibrinogen and other plasma proteins. ESR rises and falls more slowly than hs-CRP and is affected by anemia, age, sex, and pregnancy, which makes it less reproducible. ESR remains useful in rheumatology (giant cell arteritis, polymyalgia rheumatica) and certain chronic infections. For longevity and cardiometabolic wellness, hs-CRP is the more informative metric.
Educational. Not a substitute for individualized provider review.
- hs-CRP — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29