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Heart Attacks and Inflammation

A study in The New England Journal of Medicine showed that women with high levels of a blood test called C-reactive protein (CRP) which measures inflammation are twice as likely as those with high cholesterol to die from heart attacks and strokes (1). The lowest risk for a heart attack was in women whose CRP was below one-half milligram per liter of blood. Those who had both high cholesterol and high CRP were at very high risk for heart attacks.

This study followed 28,000 women for eight years. Seventy-seven percent of those who had heart attacks or strokes had cholesterol in the normal range and 45 percent were in the ideal range. Dr. Paul Ridker of Brigham and Women's Hospital in Boston found that CRP did a better job of predicting heart disease risk than cholesterol, which tells us that inflammation is more important than blood fat levels in predicting heart attacks. When a germ gets into your bloodstream, you are supposed to produce white blood cells and antibodies that help kill these germs. The white blood cells produce chemicals that cause swelling to bring fluid to carry body defense mechanisms, and other chemicals to call out other cells that increase swelling, redness and pain. So inflammation is good because it helps to protect you from infection. However, if you allow the inflammation to continue, or if your produce inflammation when you don't need it, swelling damages your tissues and you may suffer heart attacks, strokes, cancers, Crohn's disease, psoriasis, different types of arthritis, or even Alzheimer's disease.

The fatty plaque buildup that lines blood vessels often becomes inflamed because your white blood cells attack your own tissue rather than just germs. Fat cells are also known to turn out these inflammatory proteins. Other causes of inflamation include high blood pressure, smoking, obesity, and lingering low-level infections such as chronic gum disease. Inflammation is thought to weaken the fatty buildups, or plaques, making them more likely to burst. A piece of plaque can then lead to a clot that can choke off the blood flow and cause a heart attack.

Cholesterol-lowering drugs called statins can reduce the inflammation and so does a daily dose of aspirin. A study in the journal Circulation shows that older adults who had been infected with the cold sore virus (herpes simplex virus 1), as indicated by the presence of antibodies to the virus, are twice as likely to suffer a heart attack or die from coronary heart disease as those who have not been infected with the virus (1). In another study in the same issue of Circulation, researchers from the University of California in San Francisco found that people recovering from heart attacks who had high levels of white blood cells are less likely to survive the heart attack. Further studies show that people who are given antibiotics immediately after suffering a heart attack or severe chest pains have 40 per cent fewer repeat attacks over the next year. These studies suggest that you prevent heart attacks by preventing or treating causes of inflammation, which include infections anywhere in your body, gum disease, diabetes, overweight, lack of exercise, obesity, smoking or high blood cholesterol levels.

More on inflammation

1) NEJM, November 2002

2) Circulation 2000; 102: 2329-2346

Checked 3/12/12

May 19th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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