Inflammation Biggest Heart Risk Factor?

Doctors: Tests Can Determine Low-Grade Inflammation

Why do some people die of heart attacks when they have low cholesterol and are seemingly in good health?

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Is it worse than cholesterol? It's hard to believe, perhaps, but researchers say chronic low-grade inflammation creates a destructive process inside the heart -- one that may trigger heart attacks more than cholesterol.

Cowboy and Jenny Rosa are all too familiar with heart disease.

Three years ago, Cowboy Rosa was give just 18 months to live.

Jenny Rosa said salty, high-fat foods were hurting his arteries.

"It clogs them up for one thing," Jenny Rosa said. "And he does eat fat, but only once in a while. Once a month he can have fat."

"Once I changed my diet and got off the cholesterol and salt and stuff, I'm doing good," Cowboy Rosa said.

While cholesterol is certainly a major factor in heart disease, researchers note that half of all heart attack victims have cholesterol levels that are normal or even below normal. The observation led researchers to believe that something else was contributing to heart attacks.

While cholesterol is certainly a major factor in heart disease, researchers note that half of all heart attack victims have cholesterol levels that are normal or even below normal. The observation led researchers to believe that something else was contributing to heart attacks.

After accounting for obesity, smoking and high blood pressure, researchers discovered that chronic, low-grade inflammation may also cause heart attacks.

Cardiologist Robert Gillespie of the Association of Black Cardiologists said inflammation produces a chemical called C-Reactive protein.

"C-Reactive protein is simply one of the many markers that tells us inflammation is present," Gillespie said. He said inflammation may be more important than cholesterol in triggering heart attacks.

A series of landmark studies found that people with high levels of C-Reactive protein had twice the risk of heart attack compared to those with elevated cholesterol.

"When you have elevated levels of C-Reactive protein, that correlates quite well with a higher incidence of heart attack," Gillespie said. Researchers are now trying to learn what kinds of chronic conditions can raise a person's level of C-Reactive protein.

Low-grade inflammation may originate in a variety of unlikely places throughout the body, including even excess fat. New federal recommendations are being written that will urge doctors to test millions of middle-aged Americans for it.

"This will change everything we do in heart disease," one doctor said.

Doctors can measure a person's C-Reactive protein level through a simple, inexpensive blood test.

Routine testing is expected down the road for at-risk heart patients. Inflammation is not the only culprit that produces this protein. It's also produced by fat cells, which helps explain why being overweight is bad for the heart, researchers said.

The evidence about the risks of inflammation have been coming to light in the last few years. The Centers for Disease Control and Prevention and the American Heart Association held a meeting in March of 50 experts in Atlanta to review the scientific evidence on inflammation and make recommendations.

Besides inflammation, other risk factors for coronary heart disease include: