Inflammation – the natural response of the body’s immune system – can sometimes do more harm than good, particularly when it comes to heart health.
For people at risk of cardiovascular disease, the immune system’s alarms can accelerate the build-up of plaque in arteries, narrow blood vessels, and trigger inflammation that leads to life-threatening events like heart attacks or strokes.
While the link between inflammation and atherosclerosis (plaque build-up in the arteries) is well-established, new research is uncovering more precise ways to reduce cardiovascular risk by targeting inflammation effectively.
Experts like Dr Peter Libby from Harvard Medical School emphasise that inflammation interacts with cholesterol and other fats in the blood to worsen cardiovascular risk.
“Inflammation drives everything from the start of atherosclerosis to the formation of dangerous blood clots,” Dr Libby explains.
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This is why controlling both inflammation and LDL cholesterol can be crucial in preventing heart disease.
Common treatments, such as statins, are effective at lowering LDL cholesterol and have also shown to reduce inflammation, cutting the risk of heart disease for some people by 20-30%.
However, not everyone sees these benefits, and additional treatments are often needed.
New anti-inflammatory options
One promising treatment is colchicine, a drug used for gout, which has now been approved to lower inflammation in people with heart disease.
Studies indicate that, when taken alongside statins, colchicine can reduce the risk of heart attacks or strokes.
Researchers are also testing whether colchicine can be effective on its own or in combination with other therapies.
At the same time, new treatments are being developed to target specific inflammatory pathways, which could lead to safer and more effective options.
However, there is a fine balance to maintain. Dr Ahmed Hasan from the National Heart, Lung, and Blood Institute warns that targeting inflammation incorrectly could weaken the immune system, making patients more susceptible to infections. “We need to be careful about which parts of the immune system we target,” he says, highlighting the complexity of ongoing research.
Innovative techniques now allow scientists to examine immune cells and inflammation patterns more closely, revealing potential new targets for treatment.
Understanding why some patients respond well to certain anti-inflammatory drugs while others do not is a key focus of current studies.
Genetic insights
A groundbreaking area of research involves a condition called clonal haematopoiesis of indeterminate potential (CHIP), which affects around 10% of people over 70.
Certain genetic mutations linked to CHIP not only increase the risk of blood cancers but are also associated with heart disease. Scientists are investigating whether targeting inflammation in these cases could reduce cardiovascular risk.
Dr Chiara Giannarelli from New York University is looking at how genetic signatures of inflammation in immune cells can be targeted to shrink plaque in arteries. Her team has found success with an experimental therapy that reduced plaque size in animal models and human tissue samples, offering a new direction for potential heart disease treatments.
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Beyond heart disease
“Cardiovascular disease and inflammation are deeply connected to other health issues,” notes Dr Giannarelli. For example, conditions like arthritis and chronic joint pain often share underlying inflammatory processes with heart disease.
Researchers are now using insights from cancer and Alzheimer’s treatments to develop new cardiovascular therapies.
As Dr Libby puts it, “Inflammation is a common thread running through many diseases.” The hope is that by understanding and controlling this process, future treatments will not only prevent heart disease but also improve outcomes for a range of inflammatory conditions.
