markers, such as C-reactive protein in the blood, in helping to diagnose heart disease and gauge its severity. In other words, the two agencies gave the okay to doctors to start drawing a line connecting inflammation to heart disease.
In this section, we discuss common types of heart disease related to inflammation and discuss a few ways to lower your risk factors.
Looking at common types of heart disease
The types of heart disease range from a minor arrhythmia — irregular heartbeat — to a major heart attack or stroke. Symptoms and causes vary, but each one carries its own risk factors, treatment, and, in many cases, preventive measures to avoid it altogether. Here we take a look at the most common types of heart disease related to inflammation and signs you can look for to identify each one:
Cardiovascular disease: Cardiovascular disease, or atherosclerosis, is commonly known as hardening of the arteries. Cardiovascular disease is caused by a buildup of fatty plaques in your arteries which, over time, can make your arteries hard and stiff.Major risk factors of cardiovascular disease are smoking, being overweight, lack of exercise, and an unhealthy diet.
Coronary artery disease: Coronary artery disease (CAD) occurs when fatty plaque builds up in the arteries of the heart, and the CDC lists it as the most common form of heart disease in the United States. More than 7 million Americans suffer from coronary artery disease, and an estimated 500,000 Americans die from it each year.The plaque buildup can lead to angina, or chest pain that occurs when the heart doesn’t receive enough blood, which can later lead to more serious problems such as heart failure, arrhythmia, or heart attack. Symptoms of coronary artery disease include chest pain or discomfort, shortness of breath, pain in the arms or shoulder, feeling lightheaded or faint, or pain in the jaw, neck, or back.
Reducing your risk factors for heart disease
The American Heart Association reports that in 2017, approximately 116,400,000 U.S. adults had high blood pressure and 18,200,000 had coronary artery disease. The CDC estimates 647,000 U.S. adults die from cardiovascular disease each year, accounting for about 25 percent of all deaths.
PATCHING BLOOD VESSELS WITH CHOLESTEROL
LDL cholesterol molecules (the bad cholesterol) get oxidized in the blood vessels, leading to the inflammatory reactions that result in clogged arteries. It turns out that the key to high levels of LDL causing a problem is inflammation. For that reason, make sure your integrative physician tests for oxidized LDL cholesterol, not just LDL cholesterol, to truly know how much inflammation is going on in your cardiovascular system. LDL doesn’t become a risk factor until it’s oxidized by inflammation.
As the figure here shows, any type of damage to the blood vessel wall — due to infection, high blood pressure, bad food, and so on — gets the immune system involved by telling LDL cholesterol and monocytes (a type of white blood cell) to release inflammatory mediators, like CRP, to help address the damage. The monocytes continue to transform and secrete inflammatory cytokines and reactive oxygen species (ROS), creating more free-radical damage to the blood-vessel cells and more oxidation of the LDLs. This eventually turns into the atherosclerotic plaque that builds up and clogs the arteries, leading to heart attacks and strokes.
Eating a diet rich in antioxidants such as vitamin E prevents the oxidation of the LDL cholesterol molecules that initiates the inflammatory cascade that results in clogging of the arteries.
Understanding what those numbers mean and how they relate to you is an important step in taking away the fear of numbers while you tailor your lifestyle to keep you from being a statistic. The best way to do that is to look at the risk factors, compare them to your lifestyle, and make changes to reduce the risks you can control. Table 3-1 lists some of the more common risk factors for heart disease and what you can do to counteract them.
TABLE 3-1 Risk Factors for Heart Disease
| Risk Factor | What You Can Do to Reduce Your Risk |
| Smoking | Quit smoking immediately. |
| High blood pressure | Eat foods low in saturated fat and sodium. |
| Obesity | Eliminate refined sugars and processed foods; eat foods low in saturated fat. |
| Inactivity | Exercise daily. |
| Poor diet | Replace processed foods with lean meats, vegetables, and legumes. |
| Stress | Include 30 minutes of yoga in your daily routine. |
| Family history of heart disease | Eat foods low in saturated fat; increase vegetables. |
Obesity: Adding extra pounds
Although many industrialized countries have seen steady increases in the rates of obesity, none have seen as great an increase as the United States: From 2000 to 2018, the percentage of obese people in the U.S. climbed from 30.5 percent to 42.4 percent.
Blaming the fast-food industry, lack of exercise, or a general diet of overindulgence for the world’s expanding waistline is easy, but there are hidden explanations as well. Researchers are finding more and more instances in which inflammation seems not only to prevent weight loss but also to cause people to gain even more weight. Inflammation is the mediator of how poor diet and lifestyle choices, toxins, and even gene expression is influenced to increase the risk of obesity and chronic disease.
Obesity puts the body into a state of chronic, low-grade inflammation, which is born in the fat cells lying under the skin. When a body is obese, it secretes chemicals called cytokines and can have an imbalance of hormones called adipokines. These cytokines are molecules that set inflammation into motion. Some of them, interleukin-1 (IL-1) and TFN-alpha, can make you sleepy and irritable. These molecules alert the liver to act immediately, and the liver creates C-reactive protein, which is one sign of inflammation. The hormones that your fat cells produce, like leptin and adiponectin, influence your metabolism, your appetite, and your waistline. When your fat cells, called adipose tissue, is overloaded with toxins or bad fats, it creates inflammation that throws off the fat cells’ ability to function like a hormone cell tower.
HOW CORTISOL RELEASE DUE TO STRESS PROMOTES WEIGHT GAIN
When your body is under stress or your blood contains low levels of hormones called glucocorticoids, the pituitary gland in the brain secretes a hormone called acetylcholinesterase (ACTH), which signals the adrenal gland on the kidney to secrete cortisol. Cortisol is a hormone that increases blood sugar; suppresses the immune system; decreases bone formation; and affects fat, protein, and carbohydrate metabolism, which can lead to weight gain. Cortisol levels are controlled by the part of the brain called the hypothalamus.