MEDICINE AND HEALTH

A common cause of heart disease surfaced


A common but treatable factor in heart attack is overlooked. New research suggests that inflammation can be as much a key cause of heart attacks as cholesterol, so different treatments should be considered for prevention. Related papers were recently published in The Lancet.

Heart disease is one of the most common causes of death. IMAGE CREDIT: SEBASTIAN KAULITZKI

For decades, most of the attention has been focused on cholesterol. Studies have found that higher levels of “bad cholesterol” are associated with heart disease incidence. Cholesterol is also one of the main components of fatty plaque. Heart disease and stroke are usually caused by the rupture of this plaque, which causes small blood vessels downstream to become blocked.

As a result, cholesterol-lowering statins have become one of the most commonly used medications. Many large trials have found that statins are very effective in reducing heart attacks.

So why is inflammation associated with heart disease? New research shows that fatty plaques are not just inert blockages, but also immune cell activity. Animal studies have shown that plaques with higher levels of inflammation are more likely to rupture and release deadly fragments into the bloodstream. Recent evidence suggests that statins may work by suppressing inflammation and lowering cholesterol.

The Paul Ridker team at Brigham and Women’s Hospital in the United States analyzed data from three large trials. Each trial tested a therapy designed to reduce heart attacks and strokes in people taking statins. At the beginning of the trial, subjects underwent a series of blood tests, including cholesterol and a compound that is a marker of inflammation, C-reactive protein (CRP). All three trials found that high CRP was associated with more cardiovascular disease deaths compared to high cholesterol.

Ridker said: “The disease can never be defeated without eliminating the inflammatory response. This is no longer a hypothesis, but a proven fact. ”

Over the past few years, a plant-derived compound called colchicine has been used to suppress inflammation in people with gout. Two recent randomized trials showed that colchicine reduced stroke and heart attack by about 30%. In 2021, colchicine was recognized by the European Society of Cardiology guidelines as an option for the prevention of cardiovascular disease.

There is growing evidence that to prevent heart disease and stroke, doctors need to prioritize tackling inflammation and cholesterol on an equal footing. “It’s not either/or, it’s both.” Jean-Claude Tardif of the Montreal Heart Institute in Canada, who participated in one of the colchicine trials, said. (Source: China Science News, Wang Jianzhuo)

Related paper information:https://doi.org/10.1016/S0140-6736(23)00215-5



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