Middle-aged men with higher blood levels of C-reactive protein (pictured), a measure of inflammation, are at increased risk of having a heart attack or stroke in the future.
High blood pressure, elevated cholesterol, and certain lifestyle factors, such as poor diet, lack of exercise, and smoking, are major risk factors for heart disease. But research conducted at Brigham and Women’s Hospital (BWH) over the past 20 years suggests that inflammation also may contribute to heart disease risk.
Inflammation can occur as a part of the immune response, our bodies’ attempt to fight off and attack foreign substances, such as infectious diseases. Inflammation also may occur in response to the buildup of fatty deposits (atherosclerosis) inside the walls of arteries, potentially leading to the formation of harmful blood clots.
In 1997, researchers led by Dr. Paul Ridker, Director of the BWH Center for Cardiovascular Disease Prevention, discovered that middle-aged men with higher blood levels of C-reactive protein (CRP), a measure of inflammation, were at increased risk of having a heart attack or stroke in the future.
Dr. Ridker’s team made this discovery while studying aspirin, an anti-inflammatory drug. His team concluded that the benefit of being on aspirin for heart attack prevention was greater for people who had higher levels of inflammation than those who did not.
Dr. Ridker and colleagues went on to study whether statins, cholesterol-lowering drugs, also could lower inflammation. The results of the JUPITER study found that participants who had low levels of cholesterol but high levels of CRP had a lower risk of heart disease and stroke if they were given a statin.
Based on these findings, Dr. Ridker’s team has launched two additional clinical trials to study the relationship between heart disease and inflammation:
- Cardiovascular Inflammation Reduction Trial (CIRT) – studying whether low-dose methotrexate, an immunosuppressant, will reduce rates of myocardial infarction, stroke, and cardiovascular death among stable coronary artery disease patients with type 2 diabetes or metabolic syndrome.
- Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS) –testing whether canakinumab, a monoclonal antibody that targets inflammation, will reduce the risk of another cardiovascular event among men and women who have had a prior heart attack.
Though certain medications may help lower your risk of heart disease, it’s important to adopt a healthy lifestyle as well. Dr. Ridker points out that exercise and eating a diet rich in foods such as whole grains, fish, extra virgin olive oil, and nuts also can lower inflammation.
Watch this video with Dr. Ridker to learn more about inflammation and heart disease: