Heart Disease and Chronic Infections

Inflammation seen as heart attach cause _______________________________________
Article published in Bangor Daily news
04/03/97 Associated Press
Boston-
Inflammation that smolders for years inside the arteries, perhaps as a result of an infection, appears to be a powerful trigger of heart attacks and strokes and may be as bad as too much cholesterol. A new study found that after several years of this low-level inflammation men are three times as likely to have strokes. The inflammation is so subtle it shows up only on blood test and seemingly normal levels may be hazardous. Earlier studies have found signs of this inflammation at the time of a heart attack. The new work is the first to show that is simmers away while men are outwardly healthy, apparently contributing insidiously to clogged arteries. Why this microinflammtion as doctors call it , happens is still a mystery. However a leading theroy is that chronic infection with common germs might be the cause. The new research also helps explan why aspirin is so good for the heart. For years experts thought aspirin's main benefit was its interference with blood clotting. But the new study suggests it also works by fighting inflammtion inside the blood vessels. Heart attacks strike when fatty deposits build up in the arteries.When one of these deposits called plaque suddenly breaks open, blood clots form and choke off the supply of blood to the heart muscle. The ability of doctors to predict who is at risk of cardiovascular disease has come a long way but about half of those who get heart attacks and strokes have normal cholesterol levels notes Dr.Paul M.Ridker of Brigham and Women's Hospital in Boston. The theory is this:An infection attracts disease fighting white blood cells called monocytes, to the blood vessel walls. These in turn release a host of chemicals that can stimulate the growth of smooth muscle cells and contribute to the development of clogging deposits. Ridkler and colleagues studied male doctors who had taken part in a large aspirin study that began in 1982. They looked at levels of C- reactive protein , a sign of inflammtion, in 543 doctors who then went on to suffer heart attacks,strokes or vein clots after eight years of followup and an equal number who stayed healthy. The men were divided into four categories, depending on their level of this protein. Those in the top quarter had twice the risk of stroke and three times the risk of heart attacks as those in the bottom quarter. Ridker said this makes checking the level of C-reactive protein about as accurate as measuring the ratio of total cholesterol to high density lipoprotein cholesterol. That's currently the most sensitive means that doctors have in predicting a heart attack. Earlier results from the same study found that taking aspirin reduces the risk of a heart attack by 44 percent. However the latest analysis shows that those with high levels of C-reactive protein benefit most.Their risk fell 55% if they took aspirin, while aspirin had little effect on those with low levels of the protein.