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Heart Attacks: Caused by Cholesterol or Inflammation?

by Paul-Martin Foss

For decades the medical and pharmaceutical industries have pounded the drums against saturated fat and cholesterol. According to the dominant dogma, high intake of cholesterol and saturated fat leads to buildups of plaque in the arteries, causing arterial blockages that can result in heart attacks. Therefore people were counseled to reduce their intake of cholesterol and saturated fat to reduce their likelihood of suffering a heart attack.

That has also resulted in a whole host of drugs being developed that try to lower blood cholesterol, including statin drugs. But doctors still wrestled with trying to explain why half of heart attacks occur in people without high cholesterol levels. New research could indicate that cholesterol may not be the primary culprit after all.

Researchers have recently announced the results of a clinical trial that resulted from a quarter century of research into cardiovascular health. They found that they were able to significantly reduce the risk of heart attacks, strokes, and death among people who received an anti-inflammatory drug that had no effect on cholesterol levels.

All the participants in the study were also receiving statin drugs, but they were randomly assigned to receive doses of the anti-inflammatory drug canakinumab. Those receiving the highest doses of the drug saw 15 percent reductions in their risk of suffering additional cardiovascular events and a more than 30 percent reduction in their need for additional surgical procedures such as heart bypass surgery or angioplasty.

The obvious question is whether the heart attack risk reduction was due to the anti-inflammatory drug itself or whether the combination of it and statins resulted in the reduction of future cardiovascular events. But the larger implication from this study is that inflammation may play a greater role in causing heart attacks than previously though, and may be a more important factor than cholesterol. That will require further research, but could lead to more effective remedies to combat heart attacks and cardiovascular diseases.

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