Lower Inflammation to Reduce Risk of Heart Attack and Stroke
You may know that inflammation is an important aspect of health, but if you’re like most people, you don’t know exactly why. That’s understandable. Inflammation is a complex process.
Sometimes inflammation is a good thing, like when you cut yourself shaving. Your body sends cells to the source of the injury to clot blood and attack foreign substances.
Inflammation is a bad thing, however, when it happens in your blood vessels. This type of inflammation, called vascular inflammation, can lead to heart attacks, strokes, and other cardiovascular events. Of course, you can’t see vascular inflammation the way you can see redness and swelling from a cut. So how do you know if you have it?
For someone at increased risk for cardiovascular problems (for instance, someone with diabetes), a doctor may order blood tests that detect inflammation. All MDVIP members get an advanced cardiovascular risk assessment as part of their annual wellness program, which along with a customized plan is designed to help prevent heart disease. This includes a test to detect the presence of an enzyme called myeloperoxidase (MPO), a biomarker of vascular inflammation.
Recently, I co-authored a study in the Journal of International Medical Research that makes a strong case for knowing your MPO status. My colleagues and I analyzed data from more than 100,000 MDVIP patients over five years. Once we started testing for MPO as part of the wellness panel, vascular inflammation dropped in nondiabetic, pre-diabetic, and diabetic patients.
How Inflammation in the Body Causes Heart Attacks and Strokes
While cholesterol is often a factor in cardioavascular disease, about half of all heart attacks happen in people with normal cholesterol. We in the medical community have learned over the years that vascular inflammation is a major piece of the puzzle.
When plaque (often caused by small, dense particles of LDL, the bad cholesterol) attaches to the lining of your blood vessels, a fibrous cap can form over it. As blood flows through, it erodes the cap – creating something like a pothole. The body sends cells to this “injury” to help it heal.
Those cells do a few things. They clot up the top of the plaque, fixing the pothole. But they can also block the blood from flowing through, which is what leads to a heart attack or stroke.
There’s something else going on, too: white blood cells release MPO during the inflammatory process. Unfortunately, MPO contributes to the formation of more arterial plaque. If you test positive for MPO, your doctor knows you have vascular inflammation and, potentially, atherosclerosis: a disease of your arteries caused by plaque buildup.
Ways to Lower Inflammation
You know your cholesterol. Do you know your inflammatory status? Finding out you have vascular inflammation is an important first step toward lowering it, and it could be a significant factor in preventing heart disease. Our latest research found that knowledge of patients’ MPO led to a 68.5 percent reduction in risk for cardiovascular events among diabetics, a 73.7 percent reduction in risk for pre-diabetics, and a 72.2 percent reduction in risk for nondiabetic patients.
We don’t yet know exactly what the MDVIP-affiliated physicians did – and continue to do – that that leads to such good outcomes. I suspect it’s the result of our doctors working one-on-one with patients to improve their health. That may mean diagnosing diabetes in patients who didn’t know they had it. (Diabetes is a major risk factor for cardiovascular events.) It may mean adding or adjusting medications, such as statins or aspirin. It may mean recommending lifestyle changes that lower inflammation, such as healthy food choices, exercise, and stress reduction techniques.
My advice to all patients, whether or not they see an MDVIP-affiliated physician: Find out your inflammatory status, your cholesterol status, and your risk for diabetes. Once you know what may be putting your health at risk, you can work with your doctor to make improvements.
Dr. Andrea Klemes is the Chief Medical Officer of MDVIP. She also serves as the executive and organizational leader of MDVIP’s Medical Advisory Board that supports quality and innovation in the delivery of the healthcare model drawing expertise from the affiliated physicians. Dr. Klemes oversees MDVIP’s impressive outcomes data and research including hospital utilization and readmission statistics, quality of disease management in the MDVIP network and the ability to identify high-risk patients and intervene early. She is instrumental in the adoption of the Electronic Health Record use in MDVIP-affiliated practices and the creation of the data warehouse. Dr. Klemes is board certified in internal medicine and endocrinology and a fellow of the American College of Endocrinology. Dr. Klemes received her medical degree from the New York College of Osteopathic Medicine. She completed an internal medicine residency at Cabrini Medical Center in Manhattan, New York and an Endocrine and Metabolism Fellowship at the Medical College of Georgia in Augusta. Prior to joining MDVIP, Dr. Klemes worked at Procter & Gamble in the areas of personal healthcare, women’s health and digestive wellness and served as North American Medical Director for bone health. She spent 10 years in private practice specializing in endocrinology and metabolism in Tallahassee, Florida. In addition, Dr. Klemes held leadership roles with the American Medical Association, Florida Medical Association and as Medical Director of the Diabetes Center in Tallahassee and Panama City, Florida, as well as Chief of the Department of Medicine at Tallahassee Community Hospital. She has been a consultant and frequent lecturer and has completed broad clinical research in diabetes and osteoporosis and published extensively.
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