Need one more reason to quit smoking, eat right and exercise? How about inflammation?
Most people think of inflammation as the redness, swelling and warmth that accompanies a cut, injury or illness. These are symptoms of the body's immune system fighting off what it perceives as an intruder.
When that intruder is cholesterol, inflammation can wreak havoc on the cardiovascular system and may lead to a heart attack or stroke.
Dr. Dara Lee, a cardiologist with the Presbyterian Heart Group, says inflammation is a process in which the body sends white blood cells to fight invaders, such as bacterial infections or injuries. The white blood cells release helpful substances.
"Some of these substances cause the blood to clot, which can help repair a cut," Lee says. "Or they cause surrounding muscle cells to grow to repair an injury, or they attract other blood cells to fight off bacteria or other infections."
High levels of LDL cholesterol in the bloodstream are associated with plaque and narrowing in the coronary arteries. This plaque is a hot spot of inflammation, filled with cholesterol and fat and white blood cells.
Becoming a Problem
Usually, once a threat subsides, so does inflammation and healing commences. But because cholesterol continually is deposited in the arteries, the process persists, which can become a problem.
"It's like repeatedly cutting yourself day in and day out," says Dr. Warren Laskey, chief of cardiology at the University of New Mexico School of Medicine. "It gets to a point where the inflammation itself contributes to, instead of protecting, the damage in the wall of the artery." Dr. Michael McGuire, a cardiologist with Albuquerque Health Partners, adds that a barrage of white blood cells sent to fight cholesterol may worsen the problem by making the plaque around the artery wall unstable. "This is why you can have only 40 or 50 percent blockage in an artery and still have a heart attack," says McGuire. "The problem comes when one of these areas of inflammation within the plaque fractures or erodes in the opening of an artery. It's the clot that shuts the artery off, blocking the blood flow." Inflammation can occur inappropriately, such as when the body mistakenly attacks its cells as in chronic diseases such as rheumatoid arthritis or lupus, or when the infection is gone but the immune response and inflammation continue fighting, as in rheumatic fever, Lee says. "It does appear that there is some increase in risk for vascular events such as heart attacks in individuals with chronic inflammatory conditions," she says.
Preventing heart attacks is difficult in these instances. What to DoMost people can minimize their risk of heart disease caused by plaque buildup and aggravated by inflammation with changes in lifestyle, the cardiologists say. "You can't change your genes, you can't change your gender, but you can exercise and diet, exercise and diet, exercise and diet," says Laskey. "The two things that are modifiable have tremendous effects both for prevention as well as progression." Adds Lee: "All patients should follow heart-healthy lifestyles to lower their risk of heart disease, even low-risk patients." Laskey is a fan of a Mediterranean-style diet, which generally includes fruits, vegetables, whole grains, beans, nuts, seeds and olive oil. The diet also includes low to moderate amounts of eggs, fish, poultry and dairy products and wine, and little red meat or processed foods. A sedentary lifestyle also may contribute to a higher level of inflammation, the doctors say. "The human body has evolved in a way in that it's supposed to be functioning and active," says McGuire, adding exercise will help decrease overall inflammation. A Trigger McGuire and the other doctors also recommend quitting smoking to help reduce the risk of a heart attack as well as inflammatory reactions.
"Nicotine is just an incredibly toxic substance. It's poison," McGuire says. The chemicals inhaled and absorbed into the blood stream are foreign invaders that will trigger the immune system. Another possible preventive measure is brushing and flossing teeth, though the research is inconclusive as to whether a link between gum inflammation, or gingivitis, and heart disease exists. "I am not aware that this has been proven to reduce cardiac risk, but it certainly makes sense," says Lee. High-risk patients, the experts say, also should look into taking statin drugs, which seem to have an antiinflammatory effect on plaque. "We may not be able to make plaque go away, but if you can make it more stable, you -- at least theoretically -- reduce the risk of heart attack," says McGuire. A blood test can determine inflammation levels by measuring the C-reactive protein, or CRP. The protein is released into the blood stream when inflammation occurs anywhere in the body, Lee says. A low CRP level is associated with a lower risk for heart attacks and strokes. "The CRP test should generally be repeated in two to three weeks if the first read is high because several things can cause a high CRP, including an infection such as a cold or flu," Lee says. Source: Albuquerque Journal. Provided by ProQuest Information and Learning. Powered by Yellowbrix.
