Cardiovascular Health and Inflammation

February 11, 2018 | Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Cardiovascular Health and Inflammation
When it comes to getting lab results back from your latest physical, nearly everyone focuses on cholesterol levels. While total cholesterol, HDL, LDL, and triglyceride levels provide information about lipid levels, they fail to provide full insight into inflammation and its effect on the cardiovascular system. In fact, if the only focus is on lipid levels, a vast array of information is missed that is just as or even more important for cardiovascular health.

If you have heart disease or a high familial risk and all that is being evaluated is basic cholesterol markers, it’s viewing the picture from a very small view point. It’s like seeing the Grand Canyon thru a peep hole. Understanding a little bit about two inflammatory markers may help you keep your cardiovascular system healthier.

There are many risk factors associated with atherosclerosis, stroke, and heart disease. Lab markers include the most important lipid markers like HDL, triglycerides, lipoprotein A, apolipoprotein A1 and B, and lipoprotein-associated phospholipase A2. Inflammatory markers include C-reactive protein, interleukins, (IL-1, IL-6, IL-8), TNF-a, and MMP-9. There are other markers related with blood flow and clotting, cardiac biomarkers, homocysteine, vitamin D, and many others. In this article, we will focus on two key inflammation markers, i.e. C-reactive protein and IL-6.

C-Reactive Protein Linked with Cardiac Microvascular Disease

C-Reactive Protein (CRP) is a very sensitive marker for inflammation. It measures acute inflammation that affects different tissues caused by immune injury, infection and cell injury. C-reactive protein is considered a strong predictor of heart disease, such as heart attack and stroke, regardless of cholesterol levels and other factors like smoking.

The January 2018 Frontiers of Cardiovascular Medicine Journal released a recent study that evaluated high-sensitivity C-Reactive Protein (hs-CRP) in patients with ischemic heart disease and heart attacks. The purpose of the study was to assess inflammation, coronary microvascular dysfunction and heart injury. Scientists measured several values in 74 patients, 49 percent of whom were in the midst of acute coronary care. Severe microvascular disease was predictably found in males, smokers with acute cardiac symptoms, and CRP equal or greater than 3 mg/L.

Coronary microvascular disease, also known as small artery disease, refers to heart disease that affects the walls and inner lining of the heart’s tiny blood vessels. These tiny blood vessels branch off from larger coronary arteries that are affected by atherosclerosis or coronary artery disease. High-sensitivity C-Reactive Protein was concluded to be a significant predictor of coronary microvascular disease and high levels of inflammation. Injury to the small arteries of the heart significantly contributed to the pathophysiology and complications of coronary artery disease.

IL-6 Affects Heart

Interleukin-6 (IL-6) is another marker strongly linked with inflammation, especially heart health. More specifically, IL-6 is thought to play a role in the development and progression of plaque build-up in arteries. IL-6 is upstream from C-reactive protein and may play a more significant role in heart health. IL-6 is associated with several types of cardiac problems including cardiomyopathy, diastolic dysfunction, and thickened, stiff, heart valves

The Journal of the American Heart Association October 2017 published the results of their recent investigation on cardiovascular health and disease and the effects of biomarkers like CRP and IL-6. After analysis on more than 9,000 individuals over a 10-year period, they determined that there was lower risk of cardiovascular disease and better cardiovascular health when there were lower inflammatory levels of high-sensitivity C-reactive protein and IL-6 and optimal fibrinogen levels

Emotions, Inflammation, and Heart

The heart is considered the seat of emotions and it’s no surprise that depression and anxiety affect the heart. Cardiovascular disease, depression and anxiety often occur together with inflammation as elevated CRP and IL-6 levels are systemic markers that correlate cardiac and neurological inflammation. Individuals who have anxiety and depression are at higher risk of cardiovascular disease and vice versa. Research suggests a vicious cycle may occur with immune system dysregulation and inflammation that leads to perpetual co-existence of depression and cardiovascular disease.

Research also shows that personality traits affect cardiovascular disorders and CRP levels. Patients with atrial fibrillation had CRP levels evaluated, quality of life and personality types. Those who had a more distressed type personality (Type D) had higher CRP levels and lower quality of life than others with atrial fibrillation. Type D personality is described as a persistent negative or distressed attitude.

No matter how you look at these findings, the reality is the mind and body is connected. They truly cannot be separated no matter how much science and research like to compartmentalize things. When the mind is distressed, there is active inflammation throughout the body as seen by the elevated CRP and IL-6. Behavioral or mood symptoms are often the first indication of stress and reflect the need for rest and support and to manage inflammation. These emotions and personality traits do not indicate that the individual is “weak or defective”, but rather it does mean that support is needed as there is wear and tear present that affects the whole being.

Western Diet Choices Elevate CRP

Lifelong health and inflammation management begins with the diet and physical activity early in life, not just in adulthood. Recently published research has identified that today’s western diet leads to elevated CRP levels in adolescents and young adults. A January 2018 study evaluated 670 adolescent girls from various cities in the Middle East. Three types of diet were identified, i.e. traditional, healthy, and western diets. After evaluation of several factors, it was found that hs-CRP was normal in those who consumed a traditional or healthy diet. Those who consume a “western diet” had elevated hs-CRP levels.

A January 2018, Journal of Nutrition study evaluated soda consumption and its effect on CRP levels. The analysis was conducted with 825 healthy Mexican women. There was no history of diabetes, cardiovascular disease, or cancer. Average participant’s age was 45 years. Those who had the highest intake of soda had a 50 percent higher CRP level than those who had the lowest intake. The surprise finding was that there wasn’t a dramatic amount of soda consumed to have this effect. Those with the highest CRP levels consumed an average intake of about 6 ounces of soda per day. The average high soda intake was less than 12 ounces per day. Elevated CRP was identified in regular soda intake and in premenopausal women. Diet soda did not have the same effects, but diet soda has its own negative impact.

Soda and diet soda are simply non-nutritious foods that provide no health benefit to the body. The western diet of processed and package foods, high in fat, processed oils and sugar doesn’t help the body either. Heart disease doesn’t happen overnight. It occurs as an accumulation of wear and tear. Yet, our society is seeing evidence of heart disease, diabetes, and obesity in pre-teens and teenagers. We will face an epidemic of health problems in young adults if we fail to offset chronic low-grade inflammation. We start by education, diet, exercise, and if needed nutrient supplementation.

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Diet Soda Proves Fattening When Put to the Test

How the FDA is Causing the Obesity Epidemic

Help the Body Reduce Inflammation

The take away message is clear. Cardiovascular health is more than just cholesterol levels and requires the management of chronic inflammation. The western diet and soda consumption does not help, rather this lifestyle contributes to damaging inflammation and elevated CRP and IL-6. C-reactive protein is a strong predictor of small vessel or microvascular inflammation within the heart’s blood vessels. IL-6 reflects development and progression of cardiovascular disease. This battle must be won.

Dietary changes are vital. Eliminate soda intake. Use naturally flavored sparkling water if you like the bubbly, sparkling feel and taste. Avoid the western diet. The western diet is defined as a diet filled with empty calories – junk food, highly processed foods and/or fast foods. It is high in processed grains, sugar, salt, saturated fats, trans-fats, and processed vegetable oils (especially cottonseed, corn, soybean, and canola oils).

Replace those foods with organic, fresh fruits and vegetables, whole grains, seafood, poultry, some lean red meats, and beans/legumes and good oils like olive oil, coconut oil, avocado oil, organic butter or ghee. A great resource in understanding and implementing healthy choices may be found in the article The Leptin Diet Challenge # 1 Overview and Basic Needs

Physical fitness also improves CRP and IL-6 levels. Exhaustive exercise in physically unfit individuals will elevate CRP and IL-6, but when physically fit with long-term exercise, the body managees CRP and IL-6 in different ways. CRP and IL-6 actually help inflammation management, when healthy and are physically fit. Think of it, this way, if someone out of shape does an hour of physical activity, they feel exhausted and sore. Physically fit individuals, who do the same activity, will feel better, refreshed, and energized.

Nutritional Support

Several nutrients have beneficial effects on CRP and IL-6 management. One of those nutrients is magnesium. A study was conducted in Mt. Sinai’s hospital cardiac ICU on patients who had recently undergone acute abdominal aortic aneurysm surgery with intravenous magnesium. (An acute abdominal aneurysm is a life-threatening enlargement of the aorta that may easily tear or burst.) Elevated levels of CRP and IL-6 were present. Patients were given 10 grams of magnesium infused over 12 hours. In response to the treatment, CRP and especially IL-6 levels significantly decreased helping patient recovery.

A recent study evaluated multiple systematic reviews and performed a meta-analysis of randomized controlled trials. Not surprising, oral magnesium was helpful for elevated CRP levels and chronic low-grade systemic inflammation. Those who had elevated levels of CRP responded the best to magnesium intake, reflecting its vital role in inflammation management and antioxidant function.

Vitamin E, especially the tocotrienol form, is well-known for its stellar cardiovascular benefits and cardiovascular oxidative stress management. Grape seed extract has been found to lower chronic low-grade inflammation by inhibiting CRP and IL-6 and other inflammatory markers. Silymarin (milk thistle extract) and other plant-based nutrients have been found helpful to reduce CRP, IL-6 and other inflammatory markers.

In a double-blind, placebo-controlled study, 134 patients with elevated cholesterol levels were given silymarin, spinach extract and other herbal ingredients. Total cholesterol, triglycerides, LDL cholesterol, endothelial and inflammatory markers were found improved after three months of supplementation.

There is more to heart health than just the lipid markers. CRP and IL-6 amongst many other markers provide tangible evidence that chronic low-grade inflammation must be addressed in heart health, coexisting mental health and dietary challenges. Do you follow the “herd mentality” with only looking at cholesterol levels or have you addressed the bigger picture?

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