There is emerging consistency in the literature that polymorphisms in the CRP gene are associated with plasma CRP levels, but whether there is also an association between polymorphisms and risk of coronary events remains unclear. While CRP polymorphisms are strongly associated with plasma levels, these polymorphisms contribute only 1.4–5.0% of the phenotypic variation, a level comparable to (or less than) that from environmental and lifestyle factors.[9], [23] In addition to environmental stimuli, CRP is induced by other inflammatory cytokines, and additional genes in the inflammatory pathway may regulate CRP levels as well. Thus, our results are consistent with CRP as a good indicator of the inflammatory state and as a risk marker. However, the apparent influence in baseline CRP levels due to CRP polymorphisms may not be large enough to alter CHD risk, which may explain the lack of association between the majority of common haplotypes in the CRP gene and risk of CHD in either the NHS or the HPFS. The remaining exception would be haplotype 4, and it is possible that CRP is an epiphenomenon of vascular inflammation
