The Role of Inflammation and the Possibilities of Inflammation Reduction to Prevent Cardiovascular Events

Maierean, Serban and Webb, Richard and Banach, Maciej and Mazidi, Mohsen (2022) The Role of Inflammation and the Possibilities of Inflammation Reduction to Prevent Cardiovascular Events. European Heart Journal Open, 2 (4). ISSN 0195-668X

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Abstract

Chronic systemic inflammation is a risk factor for cardiovascular disease. Whether this relationship extends to subclinical inflammation, quantified by values of circulating markers associated with inflammation in the high range of the normal interval, remains debatable. This narrative review evaluates evidence exploring this relationship. A review of pharmacological and non-pharmacological interventions, including diet and lifestyle strategies, supplements, nutraceuticals and other natural substances aimed at reducing inflammation was also conducted, since few reviews have synthesised this literature. PubMed and EMBASE were used to search the literature and several well-studied triggers of inflammation (oxidised LDL, Lp(a)), as well as CRP/hs-CRP) were included to increase sensitivity and address the lack of existing reviews summarising their influence in the context of inflammation. All resulting references were assessed. Overall, there is good data supporting associations between circulating hs-CRP and cardiovascular outcomes. However, the same was not seen in studies evaluating triggers of inflammation, such as oxidized-LDL or Lp(a). There is also insufficient evidence showing treatments to target inflammation and lead to reductions in hs-CRP result in improvements in cardiovascular outcomes, particularly in those with normal baseline levels of hs-CRP. Regarding pharmacological interventions, statins, bempedoic acid, and apabetalone significantly reduce circulating hs-CRP, unlike PCSK-9 inhibitors. A variety of natural substances and vitamins were also evaluated and none reduced hs-CRP. Regarding non-pharmacological interventions, weight loss was strongly associated with reductions in circulating hs-CRP, whereas various dietary interventions and exercise regimens were not, unless accompanied by weight loss.

Item Type: Article
Additional Information and Comments: © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: inflammation, hs-CRP, cardiovascular disease
Faculty / Department: Faculty of Human and Digital Sciences > School of Health and Sport Sciences
Depositing User: Richard Webb
Date Deposited: 04 Jul 2022 13:20
Last Modified: 05 Dec 2022 12:09
URI: https://hira.hope.ac.uk/id/eprint/3560

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