Common Sense Health: Inflammation markers are tools in assessing cardiac risk

By Dr. Gifford-Jones and Diana Gifford-Jones on November 15, 2024.

Inflammation is generally the indication of a health problem. But new research suggests we think differently about inflammation, especially in relation to heart disease and the prevention of atherosclerosis (thickening or hardening of the arteries). It’s prompting debate among doctors about how to determine the risk of coronary attack and how best to treat patients.

Inflammation may sometimes be Heaven-sent, alerting us to infection and injury. This comes as no surprise, as acute inflammation is part of the natural immune response to bacterial and viral disasters. Inflammation produces a flow of proteins and hormones during an infection or injury that promotes healing. Sometimes this is obvious, as with a sprained finger.

But inflammation may also come from Hell. There are diseases like hypertension, arthritis, and coronary illness where inflammation may be a less apparent but more chronic condition – always present and silently contributing to millions of deaths annually.

The research of Dr. Paul Ridker, a cardiologist at Harvard’s Brigham and Women’s Hospital in Boston, is exploring a new approach to the treatment of patients with heart disease and atherosclerosis.

High LDL cholesterol (low-density lipoprotein, known as the “bad” cholesterol) has often been blamed as a major contributor to heart disease. But Ridker observed cases of his own patients who had suffered a coronary attack but had normal blood cholesterol levels. He studied the data of over 30,000 patients having or at high-risk of heart disease, in particular their cholesterol levels and the presence of a specific protein in the blood that is a marker of inflammation.

What he found could change the treatments doctors choose to fight atherosclerosis. The data showed that inflammation markers were a stronger predictor for risk of future cardiovascular events and death than LDL cholesterol levels. In interpreting the findings, Ridker suggests that beyond statins, aggressive lipid-lowering and inflammation-inhibiting therapies might be a better way to reduce disease risk.

Others in the scientific community note that among the causes of chronic inflammation are several enduring problems, such as obesity, diabetes and its precursors, and increasing consumption of highly processed foods. They urge a focus on diet, exercise, and smoking cessation.

But Ridker’s research does confirm that inflammatory markers in the blood can be used to assess disease risk, and potentially to treat patients differently. With a keener assessment of risk, for example, it may change the calculations regarding bypass surgery.

What about those cholesterol-lowering drugs doctors prescribe to treat high LDL cholesterol? Years ago, Duane Graveline, a physician and astronaut, was diagnosed with high cholesterol and prescribed Lipitor, a cholesterol lowering drug. Several months later he was unable to recognize his family. The drug was stopped, but later half the dose produced the same result. His experience was a highly publicized example of the mental fuzziness that can accompany use of statins.

What patients learn about side effects also determines how likely they will experience them. The risk of muscle pain from taking statins is about 5%. But in studies, nearly 30% of people stop statins because of muscle aches even when its a placebo. According to the Mayo Clinic, “A strong predictor of if you’ll experience muscle aches when taking statins could be whether or not you read about the potential side effect.”

Don’t forget, there’s another, all-natural approach to preventing and fighting atherosclerosis. Ascorbic acid (vitamin C) is a molecule with versatile anti-inflammatory properties. Big pharma won’t pay for the big studies to compare high-dose C with Lipitor or other drugs because there is no money in it. A quarter century ago, I bet my life on vitamin C after my own heart attack – and I’m still kicking.

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