This study investigates the relationship between baseline levels of C-reactive protein (CRP), a marker of systemic inflammation, and the risk of developing symptomatic peripheral arterial disease (PAD) in apparently healthy men. Using a prospective, nested case-control design, researchers measured CRP levels in 144 men who subsequently developed PAD and matched control subjects who remained free of vascular disease. The results showed that median CRP levels were significantly higher in those who developed PAD (1.34 mg/L vs. 0.99 mg/L, P=.04). The risk of developing PAD increased with each quartile of baseline CRP concentration, with relative risks ranging from 1.0 to 2.1 (P_trend=.02). Among patients requiring revascularization, the highest baseline CRP levels were observed (median=1.75 mg/L, P=.04), with relative risks from 1.0 to 4.1 (P_trend=.02). After adjusting for additional factors such as body mass index, hypercholesterolemia, hypertension, diabetes, and family history of premature atherosclerosis, the risk estimates remained similar. These findings suggest that elevated baseline CRP levels predict future risk of developing symptomatic PAD, supporting the hypothesis that chronic inflammation plays a significant role in the pathogenesis of atherothrombosis.This study investigates the relationship between baseline levels of C-reactive protein (CRP), a marker of systemic inflammation, and the risk of developing symptomatic peripheral arterial disease (PAD) in apparently healthy men. Using a prospective, nested case-control design, researchers measured CRP levels in 144 men who subsequently developed PAD and matched control subjects who remained free of vascular disease. The results showed that median CRP levels were significantly higher in those who developed PAD (1.34 mg/L vs. 0.99 mg/L, P=.04). The risk of developing PAD increased with each quartile of baseline CRP concentration, with relative risks ranging from 1.0 to 2.1 (P_trend=.02). Among patients requiring revascularization, the highest baseline CRP levels were observed (median=1.75 mg/L, P=.04), with relative risks from 1.0 to 4.1 (P_trend=.02). After adjusting for additional factors such as body mass index, hypercholesterolemia, hypertension, diabetes, and family history of premature atherosclerosis, the risk estimates remained similar. These findings suggest that elevated baseline CRP levels predict future risk of developing symptomatic PAD, supporting the hypothesis that chronic inflammation plays a significant role in the pathogenesis of atherothrombosis.