As a functional medicine provider, I understand that getting to the root cause of illness is truly the best path to healing the body, preventing disease and promoting health. Much of what people come to see me for includes hormone imbalance, gut concerns and thyroid issues. Often, we discover that inflammation is a common thread that drives many of these chronic health conditions. The cardiovascular system is equally affected by chronic inflammation, and is often overlooked until it is too late.
For many people, the first sign that they are having cardiac problems is when they actually suffer from a heart attack or some kind of cardiovascular event. The reality is that it takes years of untreated chronic inflammation and cellular damage to the heart and its vessels before most cardiovascular events occur. Research in the last decade has shown that there are very real and measurable screening tests that can be performed which can help predict risk for heart disease, and very real diet and lifestyle interventions that can significantly alter that risk.
Inflammatory changes to the lining of our arteries has been found to be a primary driver of cardiovascular damage. The endothelium (inner lining of an artery) can be damaged by things such as cigarette smoke, high blood sugar, homocysteine, infection, heavy metals, elevated blood pressure, toxins or oxidized cholesterol. When this damage occurs, the body’s natural response is to trigger an inflammatory response at the site of damage to treat and repair the problem. Often this damage is like a small tear in the endothelial lining, seemingly unimportant as a single event, but significant when left untreated. This consistent damage creates chronic inflammation which can lead to increased cholesterol, increased plaque build up in vessels, loosened plaque in blood vessels which lead to blood clots (and cause heart attack or stroke).
Not only does inflammation cause problems in our arteries, it also causes problems in our actual heart cells. Long before there are measurable findings on conventional testing like EKGs, echocardiograms and stress tests, there are changes in the cells of the heart as they struggle to function under the burden of chronic inflammation and stress. These cellular changes can lead to conditions such as enlarged heart (cardiomyopathy), decreased ejection fraction, arrhythmia's and pulmonary hypertension.
What are factors that contribute to chronic inflammation?
Factors that cause chronic inflammation are numerous and can include:
High blood pressure
High stress levels
Elevated blood sugar
Heavy metals
Circulating toxins
Altered gut microbiome
Chronic infections (sometimes these can be undiagnosed)
Obesity
Sedentary lifestyle
Sleep apnea
Diet high in refined carbohydrates
Autoimmune conditions
How do you know if you have chronic inflammation?
A functional medicine approach to assessing inflammation includes lab testing and lifestyle assessment to assess diet, exercise, sleep and stress management.
There are various ways to assess inflammation in the body:
Blood work - Perhaps the most well know screening test for inflammation is high sensitivity c-reactive protein, otherwise known as hs-CRP. Other available tests that can give us direct measurements of inflammation in the blood include homocysteine, myeloperoxidase (MPO), serum amyloid A, tumor necrosis factor (TNF-alpha) and uric acid. Advanced lipid testing can also help to give you a more in depth assessment of pro-inflammatory lipoproteins known as small dense LDL (sdLDL). Elevated serum levels of sdLDL are especially common in individuals with coronary heart disease.
Functional Heart Testing - The Multifunction Cardiogram® (MCG) is a non-invasive functional heart scan that can assess the effects of inflammation on cardiac function in minutes. It can identify signs of ischemia and other heart disease very early on, allowing for early intervention using lifestyle changes or medications. If you are interested in scheduling an appointment for a Multifunction Cardiogram® assessment, contact EMSITE Preventative Health Services at (678) 807-8627.
Additional testing that may be helpful to identify the root cause of inflammation that can drive heart disease include:
Heavy metals
Environmental toxins
Stool testing
Genetic testing
Sleep study
Micronutrient testing
What are lifestyle strategies that can prevent chronic inflammation?
Simple strategies to prevent chronic inflammation include :
Eat a Mediterranean type diet - To minimize inflammation from diet, remember to focus on anti-inflammatory foods and avoid eating refined carbohydrates (processed foods such as breads, pastas, sweets, sugared drinks, baked goods). Focus on eating high fiber foods with plant derived fats and lean proteins.
Exercise regularly - Regular exercise actually decreases inflammation. Exercise helps with stress management, improves mood, improves cognitive function and increases blood flow to all the tissues in the body.
Take extra Omega 3 supplements - Studies show that increasing omega-3 fatty acids decreases hs-CRP significantly. However, be mindful that not all omega-3 supplements are the same quality. We highly recommend that you purchase professional grade supplements, especially with omega-3s to ensure the product is clean and tested for impurities. Look for supplements that have 3:2 ratio of EPA to DHA.
Stress management and calming activities - It is equally important to take time each day to focus on calming activities and stress management. In addition to resistance training and aerobic exercise, take some time to sit outside and watch the birds, do some deep breathing exercises, draw or paint, focus on the things you are grateful for in your life. Even 10-15 minutes a day of intentional calming activities can have a profound impact on reducing the inflammatory effects of chronic stress on your body.
Our cardiovascular system is made to keep going, despite many insults and injuries. We can think about the heart as being the organ that does not complain, but just quietly keeps ticking away. It is definitely not our “squeaky wheel.” By the time the heart has to get our attention, we have caused significant harm to this essential organ. Treating the root cause of cardiovascular disease fits well in the functional medicine framework of disease prevention and health promotion. Addressing chronic inflammation is the foundation upon which we develop a heart healthy lifestyle.
Gina Ditta-Donahue is a certified Family Nurse Practitioner and Anti-Aging Medicine provider. She is the author of "Josh's Smiley Faces: A Story About Anger," a children's book aimed at helping young children and their parents navigate anger management and build adaptive life skills. She is also co-owner of Elevate Functional Medicine.