Damping down inflammation in the body appears to be just as important for fighting heart disease as lowering cholesterol, according to a pair of new studies that provide the first direct evidence that curbing inflammation can independently protect the heart.
Patients who reduced inflammation were significantly less likely to have their heart disease get worse or to die from a heart attack, even if their cholesterol levels were already low, the studies found.
The results suggest that doctors should consider routinely monitoring inflammation in the same way they test cholesterol and take steps to reduce inflammation in patients with high levels, especially in those already at high risk, the researchers said.
The same steps that lower cholesterol -- a healthful diet, exercise, weight loss, quitting smoking, and cholesterol-lowering statin drugs -- can help reduce inflammation.
For years, doctors have thought coronary artery disease occurs primarily when high cholesterol causes fatty buildups called plaques inside the arteries that supply blood to the heart, like clogging a drain.
No one knows exactly how many Americans suffer from excess inflammation, which often produces no symptoms, but doctors can detect it by testing blood levels of a protein called C-reactive protein (CRP), which goes up and down as inflammation rises and falls.
In the first study, Ridker and his colleagues gave 3,745 patients who had already suffered a heart attack or severe chest pain either normal doses of the statin Pravachol or high doses of another statin called Lipitor, and measured their CRP levels.
Those whose CRP levels dropped the lowest were the least likely to suffer or die from another heart attack, the researchers found.
In fact, cutting CRP was just as important as cutting levels of LDL cholesterol, the so-called bad cholesterol, and those with low CRP levels did better regardless of whether their LDL was high or low.