Inflammation and Heart Disease

Understand the risks of inflammation

Although it is not proven that inflammation causes cardiovascular disease, inflammation is common for heart disease and stroke patients and is thought to be a sign or atherogenic response. It’s important to know what inflammation is and what it can do to your heart.

"Think about a splinter in your finger or an abscess on a tooth," said Donna Arnett, Ph.D., chair and professor of epidemiology at the School of Public Health at the University of Alabama at Birmingham and a past president of the American Heart Association. "Our body launches an attack with our white blood cells and chemicals that results in redness and swelling to kill the bacteria or rid the body of the intruder."

Similarly, for the cardiovascular system, risk factors like cigarette smoking, high blood pressure and LDL (bad) cholesterol can "injure" the heart. In turn, atherosclerosis, the buildup of fatty deposits in the inner walls of arteries, can develop. This narrows the arteries and increases the risk they’ll become blocked.

The role of inflammation in heart attack and stroke

"Exactly how inflammation plays a role in heart attack and stroke remains a topic of ongoing research," added Deepak Bhatt, M.D. "It appears that the inciting event in many heart attacks and some forms of stroke is buildup of fatty, cholesterol-rich plaque in blood vessels."

Bhatt is chief of cardiology for the VA Boston Healthcare System, director of the Integrated Interventional Cardiovascular Program at Brigham and Women's Hospital & VA Boston Healthcare System, and associate professor of medicine at Harvard Medical School.

"The body perceives this plaque as abnormal and foreign — it does not belong in a healthy blood vessel," he said. "In response, the body tries to wall off the plaque from the flowing blood. However, under the wrong set of circumstances, that plaque may rupture, and its walled-off contents can come into contact with blood and trigger a blood clot formation."

Bhatt added, "This combination of plaque and blood clots causes the majority of heart attacks and certain types of stroke, if the blood clot obstructs blood flow to the heart or brain."

An artery to the heart that’s blocked causes a heart attack. A blocked artery in or leading to the brain causes an ischemic stroke.

More information needed; lowering risk is crucial

Cholesterol-lowering medications called statins appear to reduce arterial inflammation, but whether that’s from cholesterol reduction or something else is being debated, Bhatt said.

He added that clinical trials are ongoing to see if other medications might lower inflammation in arteries and reduce the risk of heart attack and stroke. More information on the role of inflammation should be available in the next few years.

Arnett said it’s critical to control the risk factors (cigarette smoking, high blood pressure and LDL [bad] cholesterol) that can lead to inflammation. Learn more about the key factors and behaviors to avoiding heart disease and stroke risks – what the American Heart Association calls Life’s Essential 8; – and what you can do to live a healthier lifestyle.