The stresses and strains of everyday life may be leaving a hidden mark on the heart. New research suggests that chronic inflammation linked to lifestyle, psychological distress and socioeconomic circumstances may gradually alter the heart’s structure, increasing the risk of heart attack and stroke — often years before any cardiovascular symptoms appear.
The study, led by researchers at the MRC Laboratory of Medical Sciences and Imperial College London, analysed UK Biobank data from nearly 480,000 UK adults. Researchers examined a blood marker of chronic inflammation called glycoprotein acetyls (GlycA), together with heart imaging, genetic information and health data.
People with the highest levels of inflammation had a 43% greater risk of heart attack and stroke than those with the lowest levels. Higher inflammation was also associated with structural changes in the heart, including thicker heart walls, smaller chambers and poorer filling of the heart — changes that may eventually contribute to heart failure.
Chronic inflammation is a persistent, low-level activation of the immune system. While inflammation normally plays an important role in healing and fighting infection, prolonged inflammation has been linked to conditions including diabetes, cancer and cardiovascular disease. The researchers found that elevated inflammation was associated not only with established cardiovascular risk factors such as smoking, excess body fat and physical inactivity, but also with socioeconomic disadvantage and psychological distress.
Professor Declan O’Regan of Imperial College London and the MRC Laboratory of Medical Sciences said millions of people could potentially be living with hidden inflammation that is gradually affecting their hearts. He noted that inflammation is influenced by a complex combination of lifestyle, economic, social and genetic factors, meaning that people’s circumstances may contribute to their cardiovascular risk.
The findings suggest chronic inflammation could be one biological pathway through which factors such as socioeconomic disadvantage and poor mental health affect cardiovascular health. The researchers also found a strong genetic component, suggesting some people may be naturally more susceptible or resilient to inflammation associated with different lifestyles and circumstances.
However, the researchers emphasised that genetic susceptibility or difficult socioeconomic circumstances do not mean heart disease is inevitable. Addressing modifiable risk factors such as smoking, obesity and physical inactivity may help reduce inflammation and cardiovascular risk. The study also identified inflammatory proteins from the interleukin-1 and TNF families that may contribute to heart damage. Some of these proteins are already being targeted by medicines undergoing clinical trials.
Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation, said the research highlights both the protective and potentially harmful roles of inflammation. The findings could eventually help identify people at higher cardiovascular risk before symptoms develop, potentially by combining inflammation blood tests with genetic risk information. They also reinforce the importance of addressing the social and lifestyle factors associated with chronic inflammation while investigating whether anti-inflammatory treatments could help prevent cardiovascular disease.
More information: Mattia Corianò et al, Gene–environment interactions shape cytokine-mediated inflammation and cardiovascular risk, European Journal of Preventive Cardiology. DOI: 10.1093/eurjpc/zwag435
Journal information: European Journal of Preventive Cardiology Provided by Medical Research Council (MRC) Laboratory of Medical Sciences