Inflammation and Heart Disease: What You Need to Know

Dr. Stephen Sinatra

Dr. Stephen Sinatra

08/08/2019

Many people, doctors included, are still focusing on cholesterol when it comes to preventing heart disease. But the fact is, inflammation (not cholesterol) is the most significant lifestyle-driven risk factor for the developing coronary artery disease, plaque instability, and plaque rupture.

What Is Inflammation?

Inflammation is not always a bad thing—it’s one of your body’s natural defense mechanisms. Your body’s inflammatory response is what signals the right agents to repair your cells and clear away waste. So, your body needs to know when to get into high defense mode and when not to.

Our body regulates inflammation by a “master switch” called nuclear factor-kB (NF-kB). This master switch triggers the release of inflammatory messengers, called cytokines. They tell your liver to release inflammatory mediators—such as C-reactive protein (CRP) and serum amyloid A—into your bloodstream to initiate the repair of the damaged tissues.

If it’s a one-time injury, such as a scraped knee, the inflammatory mediators do their job and your body quickly returns to normal. However, a problem arises when the inflammation is chronic—at that point it can be heart damaging.

What Causes Chronic Inflammation?

There are many causes of chronic inflammation, including infections, high blood sugar, being overweight, and having sticky blood. Any one of these situations literally feeds pro-inflammatory mediators, ratcheting up the chances that you’ll develop atherosclerosis.

But perhaps one of the biggest, and most avoidable, causes of inflammation is dietary sugar. When you eat sugar, your body releases insulin, which is one of the most endothelial unfriendly hormones around—meaning it damages the delicate endothelial lining of your arteries.

Unlike a scraped knee, damage to your arteries is chronic, which creates a constant state of inflammation in your body. At that point, instead of preventing heart disease, inflammation causes heart disease.

How Do You Know If You Have Heart Inflammation?

To determine if you have chronic inflammation, your doctor can measure your level of C-reactive protein (CRP). This inflammatory marker is directly associated with atherosclerotic plaque or heart disease. In fact, CRP has been identified as a potent predictor of future cardiovascular events in otherwise healthy men and women—one that’s far more reliable than elevated cholesterol levels.

In the Women’s Heart Study published in the New England Journal of Medicine, researchers studied the CRP in 28,000 American women. Researchers looked at CRP and LDL cholesterol levels in women who developed coronary artery disease and put them into one of four possible categories:

  • High CRP/High LDL cholesterol
  • High CRP/Low LDL cholesterol
  • Low CRP/High LDL cholesterol
  • Low CRP/Low LDL cholesterol

The results were quite surprising. Most cardiologists would have expected that women with higher levels of LDL would have been at the highest risk for inflammation and heart disease. But in this study, not only was elevated CRP the best indicator of risk, women with high LDL and high CRP were also at high risk. This is because inflammation caused LDL cholesterol to oxidize and form into plaque which can clog your arteries.

In this study, elevated CRP was the strongest predictor of future cardiac events for postmenopausal women—and other research has shown that these same findings hold true for men.

In your workup for heart inflammation, you also want to ask your doctor to test for all the inflammatory markers, including CRP, interleukin 6, serum ferritin, fibrinogen, homocysteine, and Lp(a). 

How to Keep Heart Inflammation in Check

The good news about heart inflammation is that there are many ways to keep it at bay, including:

  • Taking Boswellia serrata extract which helps to inhibit the 5-LOX enzyme that triggers inflammation
  • Eating turmeric or taking a turmeric supplement—which helps to scavenge the harmful free radicals that lead to inflammation
  • Limiting (or better yet eliminating) sugar from your diet, since sugar fuels inflammation
  • Eating a heart-healthy Pan-Asian Modified Mediterranean Diet
  • Maintaining a healthy weight
  • Reducing processed foods from your diet
  • Limiting alcohol
  • Getting moderate exercise
  • Reducing your exposure to pollution, including pesticides
  • Grounding 

Plus, Eat Foods that Promote a Healthy Inflammatory Response

There are several foods that do an excellent job of helping to keep inflammation in check—so I recommend adding them to your diet as often as you can.

  • Ginger: Not only is ginger flavorful and aromatic, science has shown that fresh ginger may help to support a healthy inflammatory response. For this reason, I often cook with ginger—adding it to stir fries and other dishes.
  • Green Tea: Few foods have as many health benefits as green tea. That’s because it contains powerful antioxidant flavonoids, including epigallocatechin gallate (EGCG), which helps to reduce oxidative stress throughout the body and protect against free radical damage. Plus, green tea contains theobromine which helps to relax the blood vessel walls to promote better circulation.
  • Pomegranate: This delicious, ruby red fruit is one of my top recommended heart-healthy super foods. That’s because it’s one of the richest sources of protective antioxidant flavonoids that support good health.
  • Cocoa Powder: As you may know, I’ve long advocated eating dark chocolate in moderation due to the antioxidant support of cocoa. The flavonoids in cocoa powder are powerful antioxidants that promote good cardiovascular health and a healthy inflammatory response—benefiting your heart and entire body.
  • Olive Leaf Tea: While slightly bitter, olive leaf tea has been widely consumed in the Middle East for a variety of reasons, including supporting heart health and immune health. You can also get the same health benefits in a more concentrated form from olive leaf extract.

Not only will keeping inflammation in check help your heart, it will also help to prevent other degenerative disease, such as diabetes, Alzheimer’s disease, and arthritis.

References
New England Journal of Medicine 2002; 347:1557-1565, 1615-1616

Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

Dr. Stephen Sinatra is a highly respected and sought-after cardiologist and nutritionist with more than 30 years of clinical practice, research, and study. His integrative approach to heart health focuses on reducing inflammation in the body and maximizing the heart's ability to produce and use energy.

More About Dr. Stephen Sinatra

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