Monday, November 17, 2008

Atherosclerosis, Inflammation and Statins

One of my favorite medical topics was addressed in the NYT today, on the opinion page no less. "Who Should Take a Statin?" discusses a recent study which had to be prematurely ended so the placebo group could get the medicine too.

I've always been convinced that levels of C-reactive protein show a strong correlation with coronary artery disease. C-reactive protein levels in your blood are an indication of overall inflammation levels in your body. The study discussed in todays NYT's showed that treatment with a statin, a cholesterol-lowering drug, not only reduced cholesterol but also resulted in reduced levels of C-reactive protein.

The effects of statin treatment were amazing.
Those who got the statin had 54 percent fewer heart attacks, 48 percent fewer strokes and 20 percent fewer deaths from all causes. The participants included men 50 and older and women 60 and older with no history of heart disease or high cholesterol. But they all had high levels of CRP, and many had such other risk factors as high blood pressure, obesity and smoking. Whether the statin helped because it reduced normal cholesterol to even lower levels or because it reduced CRP levels is not clear.
If inflammation is the cause of coronary artery disease, then what is the cause of the inflammation? Could it be infection?

There are any number of papers correlating high levels of C-reactive protein as a cardiac risk factor. Find one of them here. There have been entire scientific sessions concerning infection and atherosclerosis. One review can be found here.

I'm currently reading Paul Ewald's book "Plague Time: The New Germ Theory of Disease". Ewald points out that infections can cause chronic disease such as gastric ulcers, cancer and possibly many, many others such as IBD, arthritis, coronary artery disease and even schizophrenia. If you don't want to read Ewald's book, you can find an article in The Atlantic Online by Judith Hooper discussing the book.

The "plagues" we need to worry about are not Ebola or Bird flu. We need to start concerning ourselves with the causes of chronic diseases that are currently responsible for high mortality in the USA. Whether infections are responsible for some of these diseases needs to be seriously considered.

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