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Healthy Heart Reports

Inflammation Causes Heart Attacks

The American Medical Association has two reports that raise interesting question about the causes of heart attacks. They show that heart attacks are caused primarily by inflammation, swelling of the walls of arteries leading to the heart. We used to hear that eating a high-fat diet was the major cause of heart attacks. That would not explain why many people on low-fat diets get heart attacks. We know that having a high cholesterol is associated with increased risk for heart attacks, but many people with low cholesterol suffer from heart attacks. We hear that infection with the intracellular bacteria, chlamydia, causes heart attacks. Indeed there is a huge amount of data showing that chronic infections with chlamydia markedly increase your chances of developing a heart attack. There are studies to show that giving people the antibiotics, Biaxin or Zithromax, helps to prevent second heart attacks. Zithromax and Biaxin are two antibiotics that help kill chlamydia.

One of these new studies in JAMA shows that people who get heart attacks, have bypass surgery for blocked arteries, or have blocked arteries, have high blood levels of myeloperoxidase, commonly called MPO, an enzyme that accumulates in the bloodstream when there is inflammation. MPO is produced by white blood cells when they fight infections in your body. The other study shows that people who are hospitalized for chest pain and have high blood levels of interleukin-6 are at increased risk for dying of heart attacks. Interleukin levels are raised when a person has an infection.

From these studies and many others comes the most comprehensive theory of why people die from heart attacks. First, eating a lot of foods that cause your blood sugar to rise to high levels damages the linings of your arteries. Sugar attached to cell walls and other proteins are called Advanced Glycation Endproducts (AGE's). Eating a large amount of saturated or partially hydrogenated fats also causes your blood to thicken and roughs up the linings of your arteries. Then an infection in your bloodstream, primarily with the bacteria called chlamydia, punches holes in the arteries and causes plaques to form. The infection or something else also causes your body to set up an immune reaction, just as if it was attacking a germ, and the inflammation or swelling that results can cause clots to block your arteries, or the plaques to slip off and block the arteries, causing a heart attack.

So these studies suggest that you should treat every chronic infection. The evidence is not strong that stomach infections caused by helicobacter cause heart attacks. There is not enough evidence to tell us that we can prevent heart attacks with antibiotics in people who have a chronic cough from lung infections with chlamydia, those who have chronic urinary tract infection with chlamydia, or chronic joint pains from chronic infections with chlamydia. However, I am willing to bet you that in the near future, you will be told that chronic infections in your lungs, joints and urinary system increase your chances of getting a heart attack and the next step is to prove that taking antibiotics for these conditions helps to prevent heart attacks.

JAMA November 8, 2001


Copyright 2001
Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.

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