by Stephen Janowsky

Created on: August 01, 2008

Cardiovascular disease (CVD), particularly myocardial infarction and stroke, is the number one killer in the Western world. CVD is induced by well-known conditions like diabetes, obesity, high blood pressure and cholesterol, and cigarette smoking. However, in recent years, a new category of CVD risk factors has emerged: inflammation.

Inflammation is a non-specific reaction of our innate immune systems against various aggressions from the environment, such as microbes, toxic chemicals, or physical agents. Although designed to defend us from such potentially noxious factors, inflammation also has detrimental effects on the human body. Cells involved in inflammation, such as the white blood cells, the platelets, and the endothelial (i.e. blood vessel wall-lining) cells release various chemicals that help signalling and cooperation among these cells. These chemicals are known as acute phase reactants (such as the C-reactive protein, or CRP), cytokines (like tumor necrosis factor or TNF-alpha, and interleukins IL-1, IL-6, IL-18), coagulation factors, and cellular adhesion molecules (I-CAM, V-CAM, and selectins). All these inflammatory chemicals, when released into the blood in high amounts, will trigger a number of events that can damage our blood vessels: structural changes in circulating lipids, stimulation of coagulation factors, and endothelial injury and dysfunction. Finally, these vascular alterations may lead to atherosclerosis, thrombosis, myocardial fibrosis, and coronary heart disease, as well as insulin resistance and type 2 diabetes.

In summary, chronic inflammation promotes CVD and diabetes. High blood levels of CRP, TNF-alpha, IL-6, I-CAM, V-CAM, and selectins predict an increased risk of developing such diseases, as well as of dying from them. For this reason, they are generally termed as "CVD risk factors".

Research has shown that diets containing high amounts of trans-fat, saturated fat, cholesterol, and refined carbohydrates are associated with markers of inflammation and CVD, whereas reducing the intake of such nutrients has an opposite effect.

High consumption of trans-fats or saturated fats was associated with increased CVD risk in 80,000 women from the Nurses' Health Study, while higher intake of unsaturated fats was associated with reduced risk. In 730 women from the same study, CRP levels were 73% higher among those with the highest trans-fat intake. Markers of endothelial dysfunction, such as E-selectin, ICAM-1, and VCAM-1 were also higher.

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