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What exactly is inflammation, and how do I know if I have it?

By: Dr. Polyvios Pavlidis

Think of inflammation as the body’s response to protect itself against harm. Your immune system dispatches as army of white blood cells to surround and protect the area.

The inflammation can also occur in response to other unwanted substances in the body, such as toxins, cigarette smoke or an excess of fat cells (especially fat in the belly area). Inside arteries, inflammation helps kicks off atherosclerosis‐the buildup of fatty, cholesterol rich plaque. Your arteries perceive this plaque as abnormal and foreign, it attempts to wall off the plaque from the flowing blood. But if that wall breaks down, the plaque may rupture. The contents then mingle with blood, forming a clot that blocks blood flow.

These clots are responsible for the majority of heart attacks and most strokes. A simple blood test called hsCRP test can measure C‐reactive protein (CRP), which is market for inflammation, including arterial inflammation.

Nearly 20 years ago, Harvard researchers found that men with higher CRP levels –approximately 2 mg/liter or greater‐had three times the risk of heart attack and twice the risk of stroke as men with little or no chronic inflammation. They also found that people with greatest degree of arterial inflammation benefited the most from aspirin, a drug that helps prevent blood clots and also damps down inflammation. We recommend the hsCRP test because for the most part, we believe the results would not change. If you are young and healthy and at low risk for heart disease, there is no evidence that knowing your CRP level is helpful.

If you have heart disease, you should already be taking medications that lower your heart attack risk, such as cholesterol‐lowering statin. Aspirin and statins also appear to work particularly well in people with arterial inflammation. Statins reduce the risk of death in people with average cholesterol levels. So if you are a middle‐aged or beyond and have signs of looming heart trouble, like high blood pressure, high cholesterol, or a family history of heart disease, knowing that you have a high CRP level might nudge you toward more aggressive actions to protect your heart. These include doing regular aerobic exercise and (if needed) losing weight and quitting smoking.

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