The risks of heart disease are completely unknown to us
Most people know that the main risk factors for heart disease are high blood pressure, smoking, excess cholesterol and excess body weight. Yet many people have heart attacks who have none of these known problems.
Research now shows that conditions like gout, psoriasis, inflammatory bowel disease and rheumatoid arthritis are also some of the risk factors for heart disease. And the main similarity between these problems is chronic inflammation in the body. Lately some researchers are putting cardiovascular disease in the ranks of chronic inflammatory diseases of the arteries. Scientists sometimes refer to this as the inflammatory problem of 'atherosclerotic cardiovascular disease' or ASCVD.
The process by which inflammation occurs
Atherosclerosis occurs when fatty deposits build up on the walls of our arteries. It hardens the arteries.
When this happens in the arteries that supply oxygenated blood to the heart, it is called coronary artery disease. ASCVD can lead to a heart attack, when the heart is not getting enough blood. It can also cause ischemic stroke, where not enough blood reaches the brain. To understand why ASCVD is an inflammatory problem, we must first understand how this process begins.
In the first stage of atherosclerosis. The toxins in cigarette smoke can irritate the lining of the arteries, leading to scarring of the artery walls. When endothelial cells are injured, they send chemical messages to summon white blood cells. These white blood cells are an important component of our body's immune system. These white blood cells get inside the walls of the arteries and cause inflammation in the arteries., a lesion develops in the endothelium, a layer of cells that lines the artery walls. This can be caused by high levels of low-density lipoprotein or LDL cholesterol, which is called 'bad cholesterol'. At the same time, white blood cells also eat away the cholesterol that is stuck to the artery walls, thereby starting the formation of 'fatty streaks' on the artery walls. This is one of the first visible signs of atherosclerosis. Fatty streaks in the arteries begin to form at an early age. By the time we reach our 20s, most have some evidence of fatty streaks in their arteries. This process of endothelial cell damage, white blood cell infiltration, and inflammation can occur over years, eventually leading to plaque formation in the arteries. This may explain why people with chronic inflammatory conditions are at increased risk of cardiovascular disease. Long-term inflammation of the arteries that supply blood to the heart and brain eventually leads to heart attacks and strokes.
Silent inflammation
A heart attack occurs when one of the plaques in the arteries supplying the heart becomes unstable. This can cause the plaque to rupture. As a result, blood or other substances can clot in the arteries and blood supply to the heart muscle is interrupted. People who have a heart attack often have increased levels of inflammation and plaque instability in their arteries in the days or weeks leading up to the event. This unstable inflammatory process then reaches its peak, leading to the ultimate 'heart attack' and the resulting damage to the heart muscle. This chronic inflammatory process can occur without any symptoms. Patients with no known risk of heart disease may not realize that they have an increased risk of heart disease.
How inflammation can be measured
The good news is, there is a way to measure inflammation in the body. That is a blood test called high-sensitivity C-reactive protein (H-CRP). People with high H-CRP levels have a higher risk of heart attack and stroke. High levels of LDL cholesterol are also a risk factor for ASCVD. According to research published in the New England Journal of Medicine, people with high levels of LDL cholesterol and H-CRP are thought to be at the highest risk of cardiovascular disease.
Various studies to reduce inflammation
In a large clinical trial called Cantos, patients with high levels of H-CRP were given an anti-inflammatory drug called canakinumab after a heart attack. It found that the use of the anti-inflammatory drug reduced H-CRP levels and the number of heart attacks in patients at a small but statistically significant rate .But among those who used the drug, the risk of infection also apparently increased, the study said. Because of these risks, as well as the high cost, it is unlikely that we will be able to start using canakinumab for the treatment of ASCD anytime soon. The research was considered groundbreaking. This is because there is evidence that inflammation plays an important role in ASCVD, and reducing that inflammation can help reduce cardiovascular risk. If we can change the way we think about ASCVD risk factors, we can better identify patients who are at risk for heart attack or stroke.
In addition, this will allow us to focus more on treating inflammation to reduce cardiovascular risk.
Several studies are already looking at the use of inexpensive anti-inflammatory drugs such as colchicine and methotrexate to reduce inflammation and prevent the development of cardiovascular disease.
Lifestyle changes to reduce inflammation
The good news is that it is possible to reduce inflammation in our bodies without relying on drugs.
Everything we do in life we can categorize as pro-inflammatory or anti-inflammatory. Smoking is inflammatory. Because the toxins of cigarettes increase the irritation in the body. High levels of cholesterol in the blood and processed foods can cause chronic inflammation in our arteries. On the other hand, fruits, vegetables, whole grains and oily fish are considered anti-inflammatory. Regular exercise also helps reduce inflammation levels in the body. Obesity, especially excess weight around the waist, appears to cause chronic inflammation. If you can reduce dandruff, inflammation will also reduce. Stress can create chronic, low-level inflammation in the body, and it's important for us to try to reduce stress. Keeping blood pressure normal, cholesterol and body mass index is also very important for us. By choosing anti-inflammatory alternatives and living a healthy lifestyle, we can all reduce our risk of heart disease and improve our quality of life.
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