If you’re interested, you can read about how a coronary plaque ends up causing a blockage of the vessel and eventual ischemia. It’s often not what most people think. In this article, I will discuss the basics of how atherosclerosis and inflammation play a role in heart health.
Atherosclerosis
Plaque is the buildup inside an artery, leading to decreased blood flow and sometimes complete lack of blood flow – obstruction.
With obstruction comes ischemia – lack of oxygen to nearby tissue; not just muscle but the vessels themselves, the nerves, and connective tissue.
You need cholesterol to build up the plaque. With a total cholesterol value below 150, achieved naturally without medications, it’s rare to see someone develop much plaque in their arteries.
Another ingredient for plaque buildup is hardened vessels and increased pressures or turbulent flow of blood through those vessels. Hypertension can cause this; lack of exercise or inflammation can also contribute.
Unstable Plaque
Let’s lay the cards flat on the table – we don’t know much about inflammation. Astute clinicians can recognize inflammation when they see it. There are specific biomarkers that are helpful as well.
Inflammation adds to the problem of atherosclerotic and negatively affects heart health because it leads to unstable plaques.
A plaque is like a scab on a wound. If it’s the right time for it to come off, it’ll fall off without any bleeding. Rip it off prematurely, and you’ll get fresh blood.
That fresh blood will clot in the artery and create unstable plaque is prone to rupturing and exposing those raw surfaces. Suddenly you go from a tiny plaque to a massive clot that halts all blood flow in that artery.
Measuring Inflammation
There are several biomarkers that can tell us there is inflammation. But it’s not biomarkers alone I use in my practice.
Some people with inflammation in their bodies may never develop unstable plaque. And some with inflammation may not have much plaque, to begin with. But that might be the exception.
If someone has atherosclerosis, my goal is to increase their exercise capacity – both cardiovascular and anaerobic. Next, I want their systemic inflammation to be as low as possible.
Examples of inflammatory biomarkers:
- CRP
- ferritin
- ESR
- homocysteine
- uric acid
- triglycerides
- HDL
- platelets
- neutrophils or leukocytes
- insulin
Atherosclerosis and Inflammation
In regards to heart health, atherosclerosis isn’t a death sentence. Most of us will develop it, and less than half of us will suffer heart attacks or other complications because of it.
Preventing atherosclerosis is what I do in my program – that’s my main goal. But most of those who come to me already have atherosclerosis.
Plaque and inflammation have an essential relationship in heart health which I address with this second group. I want to decrease their total body inflammation to allow newly formed plaques or old plaques to stabilize.
Other Inflammatory Markers
No need to do these blood tests. Even without serology, we can tell if someone has inflammation.
The following are inflammatory markers I use based on signs and symptoms:
- obesity
- acne
- rosacea
- seborrheic dermatitis
- joint pain
- fatigue
- sleep disturbance
- agitation
- sound sensitivity
- GI changes
- heavy menses
- concentration issues
As you can imagine, these are rather subjective. Even if you have a little bit of all of this it doesn’t mean there is inflammation.
We use these data points as a guide. With them, we change our diet and lifestyle and reevaluate. If these markers decrease, then inflammation is likely.