Cholesterol not the only heart risk

Reducing inflammation in the body can be as protective against heart
disease as lowering cholesterol, two studies have found, sparking new
debate over strategies to monitor and prevent cardiovascular disease.

The results of the studies, published in the New England Journal of
Medicine, add weight to the argument that doctors should consider
routinely monitoring inflammation in the same way they test
cholesterol.

Inflammation, which is usually a positive reaction that occurs when the
body is fighting infection or healing an injury, can be reduced in the
same way as cholesterol is lowered - eating well, exercising, losing
weight and quitting smoking, experts said.

Researchers are now looking at new drugs to target inflammation, which
produces a C-reactive protein (CRP).

"For the first time we have hard clinical evidence that lowering
inflammation lowers the risk of heart attack and stroke and
cardiovascular disease," said Paul Ridker, a cardiologist at Brigham
and Women's Hospital in Boston, who led one of the studies.

"The magnitude of the benefit is at least as large as the magnitude of
the benefit from cholesterol reduction. This is a radical change in our
thinking about heart disease prevention."

Peter Thompson, a member of the Heart Foundation of Australia's
clinical issues committee and a cardiologist at Sir Charles Gairdner
Hospital in Western Australia, and said it was now time to consider
whether testing for inflammation should be recommended to all patients
at risk of heart trouble.

"Debate will now turn ... to taking a closer look at CRP, should we be
measuring it, and if someone is found to have high cholesterol and
[high] CRP then should they be given more aggressive treatment?" he
said.

Doctors have long thought heart disease occurred when high cholesterol
caused fatty build-up in the arteries supplying blood to the heart. The
arteries eventually narrowed and blocked, causing a heart attack.

But in recent years there has been mounting evidence that inflammation,
which can occur in those who are overweight, have high cholesterol or
suffer from a chronic low-level infection, may damage the lining of
artery walls and contribute to the formation and rupture of fatty
plaques.

"CRP is a very important marker of increased risk of heart disease," Dr
Thompson said. "This is the first time that any one has demonstrated
that lowering the CRP makes a difference."

But while there is a well-established laboratory test for CRP that has
been available in Australia for the past 15 years, Dr Thompson
cautioned that some fine-tuning was needed before it was "sufficiently
reliable to be used".

The findings also open up a whole new area of research into treatments
for elevated CRP levels, or inflammation.

"You can't simply prescribe one of the known anti-inflammatory drugs
for it," he said, pointing to recent debate around the safety of this
class of drug, while the use of cholesterol lowering statins needed
further investigation.

In the first study, Dr Ridker gave 3745 patients who had already
suffered a heart attack or severe chest pain normal doses of the statin
Pravachol or high doses of another statin, Lipitor, and measured their
CRP levels.

The statins appeared to reduce inflammation, leading scientists to
speculate that at least some of their benefit stems from their
anti-inflammatory powers. Those whose CRP levels dropped to the lowest
points were the least likely to suffer or die from another heart
attack, the researchers found.

The second study, led by Steven Nissen, a cardiologist at the Cleveland
Clinic, also found a strong relationship between the degree in
reduction in CRP and the degree of disease progression.

But Mark Pepys of the Royal Free & University College Medical School in
London said there was "no good evidence" that lowering CRP would lower
the risk of heart attack.

Additionally, there are natural ways and supplemental means to reduce systemic inflammation. A few supplements you could include in your regiment are CoQ10, organic multiple vitamin, Calcium/magnesium, fish oil and alpha lipoic acid to name a few.
Furthermore, dietary means of reducing inflammation may consist of consuming dark shaded berries, first cold pressed extra virgin olive oil, turmeric and ginger.
A vigilant practice of eating well is a great defense in combination with a life style consciousness in action.